Volume 38 Issue 9
Sep.  2022
Turn off MathJax
Article Contents
Zhou B,Gao YX,Ba T,et al.Clinical effects of ultra-pulsed fractional carbon dioxide laser in the treatment of mild to moderate microstomia after burns[J].Chin J Burns Wounds,2022,38(9):816-821.DOI: 10.3760/cma.j.cn501225-20220620-00252.
Citation: Zhou B,Gao YX,Ba T,et al.Clinical effects of ultra-pulsed fractional carbon dioxide laser in the treatment of mild to moderate microstomia after burns[J].Chin J Burns Wounds,2022,38(9):816-821.DOI: 10.3760/cma.j.cn501225-20220620-00252.

Clinical effects of ultra-pulsed fractional carbon dioxide laser in the treatment of mild to moderate microstomia after burns

doi: 10.3760/cma.j.cn501225-20220620-00252
Funds:

Science and Technology Action Plan for Prevention and Treatment of Major Diseases 2018-ZX-01S-001

More Information
  •   Objective  To investigate the clinical effects of ultra-pulsed fractional carbon dioxide laser (UFCL) in the treatment of mild to moderate microstomia after burns.  Methods  A retrospective observational study was conducted on 19 patients with mild to moderate microstomia after burns who were admitted to Inner Mongolia Baogang Hospital from January 2018 to January 2022, including 15 males and 4 females aged (35±14) years. Patients had an average course of 71 d of microstomia, with 8 cases of moderate microstomia and 11 cases of mild microstomia. All the patients received UFCL treatment every 2-3 months until the microstomia was corrected or the treatment bottleneck was reached. The times of UFCL treatment for patients and the time interval from the last treatment to the last follow-up were recorded. Before the first treatment and at the last follow-up, the opening degree of mouth (finger measurement method), oral gap width, and the distance between the upper and lower incisors during mouth opening were recorded. Before the first treatment and at the last treatment, the new Vancouver scar scale (VSS) was used to evaluate the scar. At the last follow-up, the degree of satisfaction was evaluated by the Likert 5 scale by the patients themselves, and the satisfaction ratio was calculated; the adverse reactions such as pigmentation, blisters, infection, and persistent erythema in the treatment area were counted. Data were statistically analyzed with Mann-Whitney rank sum test or paired sample t test.  Results  Patients received UFCL treatment of 3 (2, 6) times. The interval from the last treatment to the last follow-up was 26 months at most and 4 months at least. At the last follow-up, the opening degree of mouth of patients was significantly improved than that before treatment (Z=4.68, P<0.01). At the last follow-up, the oral gap width of patients was (35±6) mm, and the distance between upper and lower incisors during mouth opening was (3.2±0.4) cm, which was significantly improved compared with those before treatment (with t values of 10.73 and 18.97, respectively, P<0.01). The VSS score after the last treatment was 4.1±1.6, which was significantly better than that before treatment (t=22.96, P<0.01). At the last follow-up, the satisfaction ratio of patients with treatment was 18/19, and no pigmentation, blisters, infection, persistent erythema, and other adverse reactions of all patients in the treatment area occurred, however, one of the patients reported that the disease recurred about half a year after treatment.  Conclusions  UFCL is an effective method for treating mild to moderate microstomia after burns, with which patients are highly satisfied, and it is worth of further study and promotion.

     

  • loading
  • [1]
    沙里木江·胡纳皮亚,牙生·买买提. 胃镜口垫改制为开口器防治烧伤后小口畸形[J]. 中华烧伤杂志,2005,21(4):312. DOI: 10.3760/cma.j.issn.1009-2587.2005.04.041.
    [2]
    ZweifelCJ, GuggenheimM, JandaliAR, et al. Management of microstomia in adult burn patients revisited[J]. J Plast Reconstr Aesthet Surg, 2010,63(4):e351-e357. DOI: 10.1016/j.bjps.2009.10.026.
    [3]
    张振光, 王宽, 刘雅, 等. 扩张后颞浅动脉双蒂皮瓣矫正小口畸形及胡须再造术9例[J].中国美容医学,2018,27(2):41-43.
    [4]
    ThakurA, ChauhanD, SinglaNK, et al. Prosthetic management of microstomia with customized dynamic splint[J]. Int J Prosthodont, 2020,33(3):347-353. DOI: 10.11607/ijp.6325.
    [5]
    李丽香, 江晓声, 连丽娜, 等. 颌面部烧伤患者预防小口畸形的护理体会[J].中国美容医学,2017,26(6):122-124.
    [6]
    黄伟琪, 赵耀华, 邓海涛, 等. 应用多功能口腔矫形器防治烧伤后小口畸形[J/CD].全科口腔医学电子杂志,2014(4):33-34.
    [7]
    喜雯婧, 张铮, 李洁, 等. 点阵二氧化碳激光治疗挛缩性瘢痕的临床疗效[J].中华烧伤杂志,2021,37(8):711-717. DOI: 10.3760/cma.j.cn501120-20210624-00225.
    [8]
    弓辰, 何素霞, 李永林. 超脉冲二氧化碳点阵激光联合强脉冲光早期治疗深Ⅱ度烧伤后瘢痕的效果评价[J].中华整形外科杂志,2020,36(10):1080-1084. DOI: 10.3760/cma.j.cn114453-20200217-00050.
    [9]
    张清彬. 张清彬谈张口受限[J].国际口腔医学杂志,2017,44(5):495-502. DOI: 10.7518/gjkq.2017.05.001.
    [10]
    李丽香, 江晓声, 连丽娜, 等. 颌面部烧伤患者预防小口畸形的护理体会[J].中国美容医学,2017,26(6):122-124.
    [11]
    曹谊林,祁佐良,王炜,等. 整形外科学高级教程[M]. 北京:人民军医出版社, 2014.
    [12]
    MakiguchiT, YokooS, KoitabashiA, et al. Treatment of microstomia caused by burn with a nasolabial flap--an ingenious approach for tugging and fixation of the oral commissure[J]. J Craniofac Surg, 2014,25(2):568-570. DOI: 10.1097/SCS.0000000000000533.
    [13]
    JinX, TengL, ZhaoM, et al. Reconstruction of cicatricial microstomia and lower facial deformity by windowed, bipedicled deep inferior epigastric perforator flap[J]. Ann Plast Surg, 2009,63(6):616-620. DOI: 10.1097/SAP.0b013e3181955c9f.
    [14]
    KumarS, GuptaSH, ViswambaranM, et al. Management of postburn perioral contracture using a customized static commissural splint and intralesional injections of triamcinolone[J]. J Prosthet Dent, 2018,119(3):488-491. DOI: 10.1016/j.prosdent.2017.05.010.
    [15]
    DavisS, ThompsonJG, ClarkJ, et al. A prototype for an economical vertical microstomia orthosis[J]. J Burn Care Res, 2006,27(3):352-356. DOI: 10.1097/01.BCR.0000216458.36764.3F.
    [16]
    张晨颖, 张高飞, 娄涵潇, 等. 剥脱性二氧化碳点阵激光在烧烫伤瘢痕中的临床应用研究进展[J].实用医学杂志,2021,37(19):2554-2558. DOI: 10.3969/j.issn.1006-5725.2021.19.024.
    [17]
    StumppOF, BediVP, WyattD, et al. In vivo confocal imaging of epidermal cell migration and dermal changes post nonablative fractional resurfacing: study of the wound healing process with corroborated histopathologic evidence[J]. J Biomed Opt, 2009,14(2):24018. DOI: 10.1117/1.3103316.
    [18]
    逯艳. 二氧化碳点阵激光治疗增生性瘢痕的研究进展[J]. 中国美容医学, 2018,27(12):153-157.
    [19]
    雷颖,李石峰,喻亿玲,等 . 不同超脉冲二氧化碳点阵激光模式联合治疗面颈部增生性瘢痕的临床效果[J]. 中华烧伤杂志,2016, 32(8): 474-478. DOI: 10.3760/cma.j.issn.1009-2587.2016.08.007.
    [20]
    喜文婧,张铮,李洁,等 . 点阵二氧化碳激光治疗挛缩性瘢痕的临床疗效[J]. 中华烧伤杂志,2021,37(8):711-717.DOI: 10.3760/cma.j.cn501120-20210624-00225.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)

    Article Metrics

    Article views (1907) PDF downloads(45) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return