0479T Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children

Name of the Procedure:

Fractional Ablative Laser Fenestration of Burn and Traumatic Scars for Functional Improvement, First 100 cm² or Part Thereof, or 1% of Body Surface Area of Infants and Children.

Summary

Fractional ablative laser fenestration is a medical procedure that uses a specialized laser to treat burn and traumatic scars. The goal is to improve the functional movement in the affected area and enhance the appearance of the scar. This particular procedure is designed for infants and children, covering up to the first 100 square centimeters or 1% of their body surface area.

Purpose

This procedure addresses the physical limitations and aesthetic concerns associated with burn and traumatic scars. The primary goal is to restore functionality to the affected area, enabling better movement and reducing discomfort. Secondary benefits include improved cosmetic appearance of the scar.

Indications

• Presence of restrictive burn or traumatic scars
• Reduced mobility or functionality in the affected area
• Scars causing pain or discomfort
• Cosmetic concerns impacting quality of life

Patient criteria:

• Infants and children with the above symptoms or conditions

Preparation

• Pre-procedure consultation to assess the scar and overall health
• Possible discontinuation or adjustment of certain medications, as advised by the physician
• Fasting may be required if general anesthesia is planned
• Diagnostic tests, such as blood work, may be performed to ensure suitability

Procedure Description

1. The patient is prepared and positioned comfortably.
2. Anesthesia or sedation is administered, depending on the extent and location of the scars.
3. The targeted area of the skin is cleansed and marked.
4. A fractional ablative laser device is used to create tiny perforations in the scar tissue.
5. The laser treatment stimulates the skin's natural healing process, promoting collagen production and remodeling of the scar tissue.

Tools and equipment:

• Fractional ablative laser device
• Anesthesia or sedation equipment (if applicable)
• Sterile drapes and cleansers

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the size and complexity of the scarred area.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Dermatologist or plastic surgeon
• Anesthesiologist or nurse anesthetist (if anesthesia is required)
• Nurses and medical assistants

Risks and Complications

Common risks:

• Redness and swelling
• Temporary pain or discomfort
• Infection at the treatment site

Rare risks:

• Scarring
• Changes in skin pigmentation
• Prolonged healing process

Management of complications:

• Use of prescribed medications to manage infection or discomfort
• Follow-up appointments to monitor healing

Benefits

• Improved functional mobility in the affected area
• Enhanced cosmetic appearance of the scar
• Reduced pain or discomfort
• Results typically start to be seen within a few weeks, with continuous improvement over several months

Recovery

• Post-procedure care includes keeping the treated area clean and protected
• Application of prescribed ointments
• Avoiding sun exposure to the treated area
• Follow-up visits for monitoring and possible additional treatments
• Most patients can resume normal activities within a few days to a week

Alternatives

• Topical treatments like silicone gels or sheets
• Steroid injections
• Surgical scar revision
• Physical therapy for functional improvement

Pros and cons:

• Non-invasive alternatives like topical treatments are less painful but may be less effective for severe scars.
• Surgical options might offer more immediate results but come with higher risks and longer recovery times.

Patient Experience

• During the procedure, the patient will be under anesthesia or sedation to minimize discomfort.
• Post-procedure, mild discomfort and swelling are common and can be managed with pain relievers and prescribed ointments.
• The healing process involves gradual improvement, with some visible changes within weeks and full benefits over several months.

Overall, the fractional ablative laser fenestration procedure aims to restore functionality and improve the appearance of scars, significantly enhancing the quality of life for affected infants and children.