Sunil Srivastava1, Hiranmayi Kumari1, Abhimanyu Singh1. 1. Department of Plastic Surgery, Sawai Man Singh Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India.
Abstract
Objective: Scar biology is a territory less understood. The search for ideal treatment of keloid continues. The aim of this study was to compare the role of CO2 laser, triamcinolone (TAC), and verapamil in the treatment of keloid. Approach: A randomized parallel-group study was conducted in which 60 patients were randomly allocated to three groups from May 2017 to April 2018. First group received fractional CO2 laser therapy, second group received triamcinolone, and third group received intralesional verapamil. Outcomes were evaluated using Vancouver scar scale score at 3 weekly intervals for 6 months. Results: There was a reduction in scar height, vascularity, and pliability in all the three groups. However, pigmentation was not completely resolved by any of the three modalities. The response was fastest in case of triamcinolone followed by verapamil and laser, which was statistically significant. There was reduction in pain and pruritus in all the three groups and lesser injection site pain with verapamil. There was some amount of charring with CO2 laser. Innovation: Our study provides evidence that TAC has the fastest response in treating keloids when compared to other modalities. Scar pigmentation is the parameter that is not completely resolved by TAC, verapamil, or CO2 laser. Conclusion: The study revealed that fractional CO2 laser and verapamil are as efficient as triamcinolone acetonide (TAC) for treating keloids, except it takes longer for laser and verapamil to act compared to TAC. Verapamil can be used as an alternative treatment modality that is cost-effective with minimal adverse effects.
RCT Entities:
Objective: Scar biology is a territory less understood. The search for ideal treatment of keloid continues. The aim of this study was to compare the role of CO2 laser, triamcinolone (TAC), and verapamil in the treatment of keloid. Approach: A randomized parallel-group study was conducted in which 60 patients were randomly allocated to three groups from May 2017 to April 2018. First group received fractional CO2 laser therapy, second group received triamcinolone, and third group received intralesional verapamil. Outcomes were evaluated using Vancouver scar scale score at 3 weekly intervals for 6 months. Results: There was a reduction in scar height, vascularity, and pliability in all the three groups. However, pigmentation was not completely resolved by any of the three modalities. The response was fastest in case of triamcinolone followed by verapamil and laser, which was statistically significant. There was reduction in pain and pruritus in all the three groups and lesser injection site pain with verapamil. There was some amount of charring with CO2 laser. Innovation: Our study provides evidence that TAC has the fastest response in treating keloids when compared to other modalities. Scar pigmentation is the parameter that is not completely resolved by TAC, verapamil, or CO2 laser. Conclusion: The study revealed that fractional CO2 laser and verapamil are as efficient as triamcinolone acetonide (TAC) for treating keloids, except it takes longer for laser and verapamil to act compared to TAC. Verapamil can be used as an alternative treatment modality that is cost-effective with minimal adverse effects.
Entities:
Keywords:
CO2 laser; comparison; keloid; triamcinolone; verapamil
Authors: Thomas A Mustoe; Rodney D Cooter; Michael H Gold; F D Richard Hobbs; Albert-Adrien Ramelet; Peter G Shakespeare; Maurizio Stella; Luc Téot; Fiona M Wood; Ulrich E Ziegler Journal: Plast Reconstr Surg Date: 2002-08 Impact factor: 4.730
Authors: Basil M Hantash; Vikramaditya P Bedi; Bhumika Kapadia; Zakia Rahman; Kerrie Jiang; Heather Tanner; Kin Foong Chan; Christopher B Zachary Journal: Lasers Surg Med Date: 2007-02 Impact factor: 4.025
Authors: Rafael Leszczynski; Carolina Ap da Silva; Ana Carolina Pereira Nunes Pinto; Uliana Kuczynski; Edina Mk da Silva Journal: Cochrane Database Syst Rev Date: 2022-09-26
Authors: Engy Abd El-Hamid El-Azhary; Fatma Mohamed Abd Al-Salam; Hala Shawky Abd El-Hafiz; Hala Maghraby Maghraby Journal: Dermatol Pract Concept Date: 2022-04-01
Authors: Yu Na Han; Yoon Jae Lee; Ki Joo Kim; Su Jin Lee; Jang Youn Choi; Suk-Ho Moon; Jong Won Rhie Journal: Tissue Eng Regen Med Date: 2021-01-29 Impact factor: 4.169