Extralesional cryotherapy combined with intralesional triamcinolone injections after keloid excision

IF 0.2 Q4 SURGERY
S. Jwa, J. Won, Y. Suh, Won Jai Lee
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Abstract

Background Keloid treatment is challenging because of the high likelihood of recurrence and a lack of definitive treatment combinations. The treatment of bulky and recurrent keloids is particularly difficult. We investigated the administration of extralesional cryotherapy (EL) in conjunction with intralesional (IL) triamcinolone (TA) injections as adjuvant therapy after surgical excision for the management of keloids.Methods Among all patients who visited our scar laser center between January 2016 and August 2017, 54 patients who underwent IL keloid excision with EL cryotherapy and IL TA injection as adjuvant therapy were included in this retrospective study. We examined sex, site, the number of cryotherapy sessions and TA injections, symptoms after surgery, and recurrence. The Vancouver Scar Scale (VSS) was used as to quantify treatment outcomes.Results Among 54 cases of IL keloid excision, after an average of 6.26 cryotherapy sessions and IL TA injections as combined adjuvant treatment, the lesion was controlled without recurrence in 49 cases. Relapse occurred in five patients, requiring additional treatment and reoperation. For 49 patients with photographic data, the average VSS score before and after treatment improved from 10.1 to 5.0. In 17 patients in whom symptoms recurred after surgery, all symptoms were controlled and maintained with adjuvant therapy.Conclusions Initial direct surgical excision, followed by a combination of EL cryotherapy and IL TA injections, was shown to be effective in challenging cases of large and recurring keloids.
瘢痕疙瘩切除后病灶外冷冻联合病灶内注射曲安奈德
背景瘢痕疙瘩的治疗具有挑战性,因为复发的可能性很高,而且缺乏明确的治疗组合。治疗体积庞大和复发性瘢痕疙瘩特别困难。我们研究了瘢痕疙瘩手术切除后,病灶外冷冻治疗(EL)联合病灶内注射曲安奈德(TA)作为辅助治疗的方法。方法在2016年1月至2017年8月期间访问我们瘢痕激光中心的所有患者中,54名患者接受了IL瘢痕疙瘩切除术,采用EL冷冻治疗和注射IL TA作为辅助治疗。我们检查了性别、部位、冷冻治疗次数和TA注射次数、手术后症状和复发情况。温哥华疤痕量表(VSS)用于量化治疗结果。结果在54例瘢痕疙瘩切除患者中,49例患者经平均6.26次冷冻治疗和注射IL-TA联合辅助治疗,病变得到控制,无复发。5名患者出现复发,需要额外治疗和再次手术。对于49名有照片数据的患者,治疗前后的平均VSS评分从10.1提高到5.0。在17例术后症状复发的患者中,所有症状都得到了控制,并通过辅助治疗得以维持。结论首次直接手术切除,然后联合EL冷冻治疗和IL-TA注射,对具有挑战性的大面积和复发性瘢痕疙瘩是有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
33.30%
发文量
35
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