Comparison of Different Modalities of Treatment of Hypertrophic Scars and Keloids

Abstract

Introduction: Hypertrophic scars and keloids are extreme overgrowth of scar tissue.

Aims and objectives: To improve the cosmesis and symptomatology, to compare the results of different treatment modalities and to find out the most workable treatment option.

Study design: Prospective randomized clinical trial.

Place and Duration of Study: This study was conducted at the Allied Hospital, Faisalabad from April 2009 to September 2011.

Materials and Methods: In this study 72 patients were studied. Most of them were treated on outdoor basis while others in wards.  Detailed history and physical examination were carried out and applied different treatment options and followed them up.

Results: In our study of patients of hypertrophic scars and keloids, 29 were males and 43 were females. There was 20 % recurrence rate in intralesional injections of steroid, 25 % in silicone gel sheeting, 25 % in surgery and postoperative intralesional injection, 50 % in case of surgery and postoperative irradiation and 20 % in surgery alone. In case of intralesional injections of triamcinolone acetonide 62.5% patients had excellent results. In both silicone gel sheeting and surgery with steroid injections 50% had excellent results. In 2 patients in whom we combined surgery with radiotherapy 1 patient improved while the other got recurrence. After surgical excision of hypertrophic scars 40% patients had excellent results.

Conclusion:  Intralesional injections of triamcinolone acetonide had good results. In early lesions silicone gel sheeting was useful option while recurrent scars can be treated by combined modalities of treatment.