Burn Sunnybrook Magazine Sunnybrook Magazine - Spring 2020

How a specialized laser treatment is helping patients heal after severe burns

Anna Janiszewska.

Sunnybrook is the first adult burn centre in Canada to treat severe burns with a specialized laser. The results are offering some patients a new recovery path.

(Photography by Kevin Van Paassen)


Hairstylist Anna Janiszewska spends hours on her feet, moving frequently as she skillfully manoeuvres her clients’ hair into place. It would be strenuous work for anyone, but it’s made even more difficult for the 43-year-old Toronto resident because of burns she suffered when the ethanol-fuelled tabletop fire pot in her living room exploded while she was trying to light it.

The burn has healed, but a scar extends from her face down to her stomach, making it difficult for her to move freely.

“I feel like the skin is pulling, especially on the chest,” Anna says. “I’m constantly hinged forward, because the [damaged] skin is pulling me forward.”

The scar isn’t just affecting her work. Anna sometimes wakes at night with blood-stained sheets from having scratched her itchy skin in her sleep. Getting back to her daily gym routine has been painful. Then there’s the cosmetic aspect of having a red, aggressive-looking mark covering a significant portion of her body.

But all that is about to change.

Anna is part of a small group of people receiving specialized laser treatment for their scarring at Sunnybrook – treatment she hopes will ease the redness, itching and tightness of the scar and improve her quality of life.

The specialized type of laser made its first debut in Canada for paediatric patients at the Hospital for Sick Children. Sunnybrook was so encouraged by its positive results that the hospital actively fundraised to bring the laser to its Ross Tilley Burn Centre.

Donor funding played a significant role in bringing this specialized laser to Sunnybrook, the first of its kind in an adult hospital in Canada.

Dr. Marc Jeschke, director of the Ross Tilley Burn Centre, says he is pleased by the improvements his patients have experienced. He notes that for many patients, burns are lifelong injuries that cause significant pain and suffering long after the initial incident, which makes any improvements all the more meaningful.

“So far, every patient has had a remarkable response,” Dr. Jeschke says of the laser treatments. Patients have been able to sleep better at night, move their heads or hands more easily, experience less pain and generally just feel – and look – more like themselves, he adds.

Dr. Jeschke explains that the laser works by inducing perforations into the skin, including the thick and stiff collagen bands of scar tissue. As the scar re-heals, the skin is essentially remodelled to be looser, lighter and more flexible.

While the technique is effective for patients with acute burn injuries, it can also reawaken a therapeutic healing process for patients with longer-term scars, which is exactly what it did for Yasmin.

Syrian-born Yasmin, whose name has been changed to protect her privacy, was the first person to undergo laser therapy at the burn centre in July last year. When Yasmin was just two years old, she fell into hot oil and suffered severe burns to her neck, shoulders and arms. According to Dr. Jeschke, Yasmin underwent surgery in her home country, but the burns didn’t heal well and left her head’s range of motion extremely limited.

After a series of reconstructive surgeries at Sunnybrook, Yasmin was able to stand tall and look around properly. But she still faced daily discomfort due to pulling from the edges of the wound.

Since having a single laser treatment, Yasmin says she can already see results.

“I do not feel any pain or side effects and can see it looks better already,” Yasmin says through a translator. “Before the laser, the skin was thick and folded, but after the first session, the skin is [more even].”

Yasmin will continue to receive laser treatments every few months. She says she’s looking forward to “looking as normal as possible” and getting on with her university studies, as well as her new life in Canada.

“This scar has made me feel like I was different, and Dr. Jeschke was the only doctor who gave me so much hope and support. I am really grateful to him and his team,” she says.

Dr. Jeschke discusses the laser procedure with Anna.

Dr. Jeschke discusses the laser procedure with Anna (Photography by Kevin Van Paassen)

The procedure is relatively straightforward, Dr. Jeschke says. Patients check in to the hospital either the evening before or the day of the treatment. They are sedated, have the laser treatment, wake up an hour or so later and are able to go home the same or the next day. After a few months of healing, patients can have another laser session. Dr. Jeschke says most patients will require up to four or five sessions, although it depends on each individual case.

Patients also don’t have to pay out of pocket for the procedure. Because the treatments are covered by OHIP, patients are spared the tens of thousands of dollars it can cost to travel to other countries for treatment, such as the United States.

As for Anna, she has received her second treatment with the laser and says she has already noticed a difference.

“My scar is definitely a little lighter, because my scars were really red,” she says. “It definitely helped.”

She’s looking forward to more treatments, and further recovery, in the weeks ahead.

The dangers of ethanol fire pots

Last year, four people were admitted to Sunnybrook’s Ross Tilley Burn Centre with injuries related to ethanol fire pots, also known as tabletop firepits, portable fireplaces, fire bowls and patio burners. One of those incidents was fatal.

Burns can occur when these units are in use because of a design flaw with the burning mechanism: They need to cool down completely before being refuelled or else they can become like a blowtorch, “flame-jetting” and spewing flames back at the person. Ethanol fumes emanating from the fire pots themselves, or fumes from a person’s perfume or hairspray, become highly flammable. The incidents are unexpected, sudden and frequently devastating.

The effects of fire pot-induced burns are not only physical but also psychological, says Anne Hayward, a social worker at the Ross Tilley Burn Centre. She adds that severe burns can also have a huge psychological impact on victims’ families.

“I don’t think people fully appreciate what that is like for people, and the toll it takes,” she says.

Ethanol fire pots are popular items in Canadian backyards, because they create beautiful flames and don’t need regular stoking, like wood fires do. There’s added risk, though, because the fire pots are often used in social settings, where people aren’t necessarily paying attention to the flames.

“People feel that they’re safer because they look pretty and they’re [often on a] tabletop. [When someone’s] guard is down, the awareness isn’t the same,” says Hayward.

Health Canada issued an alert in 2019, stating that certain types of fire pots and portable fireplaces are dangerous and now prohibited, but it did not name specific brands or models.

The Office of the Fire Marshal of Ontario released the following recommendations for using ethanol-fuelled fire pots safely:

  • Leave the device to cool down for at least 30 minutes, and make sure it’s cold to the touch before refuelling
  • Make sure the units are on a stable and level surface
  • Keep pourable fuels away from flames or anything that can make a spark
  • Refuel away from people
  • Use a fuel canister with a flame arrestor (a small mesh insert) to prevent flame-jetting

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Mirjam Guesgen