Enhanced Scar Reduction with Triamcinolone Acetonide and Botulinum Toxin A Combination Therapy Compared to Botulinum Toxin A Monotherapy: A Translational Pilot Study.
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引用次数: 0
Abstract
Background: The efficacy of combining triamcinolone acetonide (TAC) and botulinum toxin type A (BTX-A) in treating hypertrophic scars and keloids remains unclear.
Objectives: This pilot study aimed to compare the clinical efficacy of BTX-A monotherapy and TAC + BTX-A combination therapy in improving scar conditions and to investigate potential mechanisms using a rat burn scar model.
Methods: This study was conducted between March 2022 and December 2024. Each patient's scar was randomly divided into two equal parts, with one part receiving TAC + BTX-A and the other BTX-A alone for three sessions at four-week intervals. Scar thickness was measured using calipers, and the Vancouver Scar Scale (VSS) was used to assess scar condition. Pain and itchiness were evaluated using the Numeric Rating Scale (NRS) and Visual Analog Scale (VAS), respectively, before each intervention (V1, V2, V3) and four weeks after the last session (V4). In the animal study, rats with burn scars were assigned to five groups: sham, untreated burn, TAC, BTX-A, and TAC + BTX-A. Scar thickness and expressions of α-SMA, TGF-β, CTGF, collagen I/III, laminin, and fibronectin were analyzed histologically.
Results: Clinically, both therapies reduced scar thickness, VSS, NRS, and VAS scores. However, combination therapy showed superior reductions in scar thickness (V2-V4) and VSS scores (V3, V4) compared to BTX-A monotherapy. No significant differences were observed in NRS and VAS scores. The animal study confirmed that combination therapy more effectively reduced scar thickness, TGF-β and CTGF levels, and the collagen I/III ratio, while increasing the laminin/fibronectin ratio.
Conclusions: TAC + BTX-A combination therapy enhances scar reduction by more effectively suppressing fibroblast proliferation and activation through TGF-β and CTGF downregulation, promoting scar remodeling.
期刊介绍：
Aesthetic Surgery Journal is a peer-reviewed international journal focusing on scientific developments and clinical techniques in aesthetic surgery. The official publication of The Aesthetic Society, ASJ is also the official English-language journal of many major international societies of plastic, aesthetic and reconstructive surgery representing South America, Central America, Europe, Asia, and the Middle East. It is also the official journal of the British Association of Aesthetic Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery and The Rhinoplasty Society.
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