Abstract

Burns are a global public health issue. Due to improvements in burn management, mortality rates are reducing, resulting in burns being a leading cause of morbidity globally (WHO 2023). Up to 70% of patients develop hypertrophic scars after burns (Finnerty et al., 2016) as well as other associated physical (itching, pain, tightness and limited joint mobility) and psychological complications (low mood, anxiety and PTSD). These complications have a significant impact upon the individual’s quality-of-life which Finnerty et al., (2016) argues is the greatest unmet challenge in burn rehabilitation. Current treatments for burn scar management include moisturisation, silicone gel, pressure therapy, corticosteroid injection, and splinting. There are minimal trials exploring the use of laser treatment; there is an early randomised controlled trial (RCT) on effectiveness of ablative fractional laser (Lewis et al., 2023), however there are no RCTs exploring the use of Pulsed Dye Laser (PDL). Furthermore, there is also a lack of discussion regarding the holistic assessment of the effects of scar management interventions (Mathers 2022).

This presentation reports upon the qualitative component of a National Institute of Health Research Council (NIHR) funded multicentre parallel arm RCT exploring the use of PDL in early scar management. The qualitative component sought to explore participants’ experiences of their scar management, impact upon their life and experiences of PDL. This is to our knowledge the first qualitative study exploring the patient experience of PDL in early scar management. This study included telephone interviews (n=20) from the larger RCT sample (n=138). Participants were recruited across a range of demographic, burn and burn management details (gender, age, treatment (PDL or standard care), Fitzpatrick skin type, burn location, TBSA%, Depth of burn and clinical site). Interviews were analysed using Reflexive Thematic Analysis (Braun and Clarke 2022) and five themes were constructed: they don’t seem to know what they’re doing, feeling disconnected, human and financial costs (including 4 sub themes, having to adapt, money worries, it’s changed how I feel about myself and it doesn’t just affect me), Pulse Dye Laser and moving forwards. Using the Life Thread Model (Ellis-Hill et al., 2008) these findings are discussed, highlighting the need for a much more integrated programme of burns rehabilitation.

Notes

References:

Braun V, Clarke V. Thematic analysis: a practical guide. London: Sage; 2022
Ellis-Hill, C., Payne, S., Ward, C., 2008. Using stroke to explore the Life Thread Model: An alternative approach to understanding rehabilitation following an acquired disability Disability and Rehabilitation,

Lewis CJ, Douglas H, Martin L, Deng Z, Melton P, Fear MW, Wood FM, Rea S. Carbon dioxide laser treatment of burn-related scarring: Results of the ELIPSE (Early Laser Intervention Promotes Scar Evolution) prospective randomized controlled trial. J Plast Reconstr Aesthet Surg. 2023 Sep;84:368-376. doi: 10.1016/j.bjps.2023.06.012.

Finnerty, CC., Jeschke, MG., Branski, LK., Barret, JP., Dziewulski, P., Herndon, DN.., 2016. Hypertrophic scaring: The greatest unmet challenge after burn injury. Lancet 388; 1427-1436.

Mathers, J.M., 2022. Towards the holistic assessment of scar management interventions. European Burn Journal 3, 207-210. Doi.org/10.3390/ebj3010018.
World Health Organization., 2023. Burns. Available from: https://www.who.int/news-room/fact-sheets/detail/burns [accessed 23.10.24]

Description

Burns are a leading cause of morbidity globally and can have significant negative impacts upon individuals’ quality of life. Burns rehabilitation is fundamental to people adjusting to living with burn scars yet there are limited studies exploring the use of Pulse Dye Laser in hypertrophic burns scar management. This presentation reports on the qualitative component of a RCT examining the use of Pulse Dye Laser in early scar management as well as the impact of living with their scar.

Author Details

Professor Vanessa Heaslip, PhD, MA, BSc (Hons), DipHe, RN, DN, University of Salford, Manchester, UK;

Sharon Docherty, PhD, Bournemouth University, Poole, Dorset, UK;

Shelley Rhodes, PhD, University of Exeter, Exeter, Devon, UK;

Obioha, Ukoumunne, PhD, University of Exeter, Exeter, Devon, UK;

Katie Breheny, University of Bristol, Bristol, UK & NIHR ARC West, Bristol, UK;

Kate Attrill, Chelsea and Westminster NHS Foundation Trust, London, UK;

Jonathon Pleat, North Bristol NHS Trust, Bristol, UK;

Mark P. Brewin, PhD, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, UK

Sigma Membership

Phi Mu

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Qualitative Research

Keywords:

Academic-Clinical Partnership, Acute Care, Long-term Care, Burn, Burn Scars

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-11-18

Funder(s)

National Institute for Health and Care Research, United Kingdom

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Early Laser for Burns Scars (ELABS): A Qualitative Exploration

Indianapolis, Indiana, USA

Burns are a global public health issue. Due to improvements in burn management, mortality rates are reducing, resulting in burns being a leading cause of morbidity globally (WHO 2023). Up to 70% of patients develop hypertrophic scars after burns (Finnerty et al., 2016) as well as other associated physical (itching, pain, tightness and limited joint mobility) and psychological complications (low mood, anxiety and PTSD). These complications have a significant impact upon the individual’s quality-of-life which Finnerty et al., (2016) argues is the greatest unmet challenge in burn rehabilitation. Current treatments for burn scar management include moisturisation, silicone gel, pressure therapy, corticosteroid injection, and splinting. There are minimal trials exploring the use of laser treatment; there is an early randomised controlled trial (RCT) on effectiveness of ablative fractional laser (Lewis et al., 2023), however there are no RCTs exploring the use of Pulsed Dye Laser (PDL). Furthermore, there is also a lack of discussion regarding the holistic assessment of the effects of scar management interventions (Mathers 2022).

This presentation reports upon the qualitative component of a National Institute of Health Research Council (NIHR) funded multicentre parallel arm RCT exploring the use of PDL in early scar management. The qualitative component sought to explore participants’ experiences of their scar management, impact upon their life and experiences of PDL. This is to our knowledge the first qualitative study exploring the patient experience of PDL in early scar management. This study included telephone interviews (n=20) from the larger RCT sample (n=138). Participants were recruited across a range of demographic, burn and burn management details (gender, age, treatment (PDL or standard care), Fitzpatrick skin type, burn location, TBSA%, Depth of burn and clinical site). Interviews were analysed using Reflexive Thematic Analysis (Braun and Clarke 2022) and five themes were constructed: they don’t seem to know what they’re doing, feeling disconnected, human and financial costs (including 4 sub themes, having to adapt, money worries, it’s changed how I feel about myself and it doesn’t just affect me), Pulse Dye Laser and moving forwards. Using the Life Thread Model (Ellis-Hill et al., 2008) these findings are discussed, highlighting the need for a much more integrated programme of burns rehabilitation.