Name of the Procedure:

Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm², or each additional 1% of body surface area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Summary

Fractional ablative laser fenestration is a medical technique used to treat and improve the function of burn and traumatic scars. The procedure utilizes laser technology to create tiny perforations in the scar tissue to promote healing and improve skin function.

Purpose

The primary purpose of this procedure is to alleviate the physical limitations and discomfort caused by severe scars resulting from burns or trauma. The goal is to enhance the flexibility, appearance, and overall function of the affected skin areas.

Indications

• Presence of restrictive burn or traumatic scars.
• Reduced range of motion or functional impairment due to scarring.
• Chronic discomfort or pain associated with scar tissue.
• Children and infants with significant scar tissue that impacts growth and development.

Preparation

• Patients may be advised to avoid certain medications that can increase bleeding risk (e.g., aspirin, certain anti-inflammatories) a few days prior to the procedure.
• Fasting might be required if sedation or general anesthesia will be used.
• Pre-procedural imaging or assessment of the scar tissue to determine the extent and areas in need of treatment.

Procedure Description

1. The targeted scar area is cleaned and prepared.
2. Local anesthesia, topical numbing cream, or sedation may be administered based on the extent of the treatment and patient comfort.
3. A fractional ablative laser device is used to deliver precise laser energy to the scar, creating tiny holes or "fenestrations" in the tissue.

4. The laser-induced micro-injuries stimulate the body's natural healing process, promoting the generation of new, healthy skin tissue.

   Duration

   The procedure duration varies depending on the size and number of scars treated but generally ranges from 30 minutes to 2 hours.

Setting

This procedure is typically performed in an outpatient clinic, specialized dermatological office, or surgical center.

Personnel

• Dermatologist or plastic surgeon
• Nurses or medical assistants
• Anesthesiologist (if general anesthesia is required)

Risks and Complications

• Temporary redness, swelling, or discomfort at the treatment site.
• Risk of infection at the laser-treated areas.
• Hyperpigmentation or hypopigmentation of the treated skin.
• Rarely, scarring or changes in skin texture.

Benefits

• Improved skin flexibility and reduced functional limitations caused by scarring.
• Enhanced aesthetic appearance of scarred areas.
• Overall healthier and more resilient skin.

Recovery

• Patients may experience redness and swelling for a few days post-procedure.
• Keeping the treated area clean and moisturized is crucial for optimal healing.
• Avoid direct sun exposure and use sunscreen to protect the treated skin.
• Follow-up appointments may be scheduled to monitor healing and address any concerns.

Alternatives

• Topical treatments like silicone sheets or scar creams.
• Surgical scar revision.
• Non-ablative laser treatments or other types of laser therapy.
• Microdermabrasion or chemical peels.

Patient Experience

Patients may feel a sensation of warmth or slight discomfort during the procedure, typically managed with local anesthesia or sedative options. Post-procedure, there may be mild pain and swelling, which can be alleviated with prescribed pain relief measures and proper aftercare instructions provided by the medical team.