مجله جهانی جراحی پلاستیک
مجله جهانی جراحی پلاستیک
دوشنبه 10 آذر 1404
[Archive]
چکیده: (475 مشاهده)
Background: Hypertrophic scars (HTS) and keloids are the proliferative responses of the fibroblastic. Surgical excision lead to changes, but postoperative recurrence rate seems to be still high. The topical use of mitomycin C (MMC) has been thus documented to suppress fibroblast proliferation. We aimed to investigate the effects of MMC injection on HTS and keloids in burn wounds, and compare the results with intralesional Triamcinolone Acetonide (TAC) injection in with regard to scar size reduction.
Methods: This randomized clinical trial was conducted on 90 burn patients (divided into two groups) with hypertrophic scars and keloids at Taleghani Burn Hospital, Ahvaz, Iran, in 2023. Patients were randomly assigned to receive intralesional MMC (0.4 mg/dL) or TAC (0.4 mg/dL). Scar characteristics were assessed pre- and post-treatment using the Vancouver Scar Scale (VSS) over six months.
Results: The average size of the scars at the pre- and post-intervention stages was 15.71 and 4.81 mm. No significant difference was observed between both groups. Effect of MMC was over and above TAC. There was a significant difference between both groups. Significant difference was found between the Vancouver Scar Scale (VSS) mean scores before and after the intervention, so the TAC value was greater than that of MMC, and the scores at the pre- and post-intervention stages were significantly different.
Conclusion: MMC and TAC were considered as effective methods for HTS and keloid management. In spite of this, the VSS scores and the scar size denoted that MMC was much more effective in the treatment of such scars than TAC.
Methods: This randomized clinical trial was conducted on 90 burn patients (divided into two groups) with hypertrophic scars and keloids at Taleghani Burn Hospital, Ahvaz, Iran, in 2023. Patients were randomly assigned to receive intralesional MMC (0.4 mg/dL) or TAC (0.4 mg/dL). Scar characteristics were assessed pre- and post-treatment using the Vancouver Scar Scale (VSS) over six months.
Results: The average size of the scars at the pre- and post-intervention stages was 15.71 and 4.81 mm. No significant difference was observed between both groups. Effect of MMC was over and above TAC. There was a significant difference between both groups. Significant difference was found between the Vancouver Scar Scale (VSS) mean scores before and after the intervention, so the TAC value was greater than that of MMC, and the scores at the pre- and post-intervention stages were significantly different.
Conclusion: MMC and TAC were considered as effective methods for HTS and keloid management. In spite of this, the VSS scores and the scar size denoted that MMC was much more effective in the treatment of such scars than TAC.
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فهرست منابع
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23. Ung CY, Warwick A, Onoufriadis A, Barker JN, Parsons M, McGrath JA, Shaw TJ, Dand N. Comorbidities of Keloid and Hypertrophic Scars Among Participants in UK Biobank. JAMA Dermatol. 2023; 159(2):172-181. [DOI:10.1001/jamadermatol.2022.5607]
24. Sengupta A, Das A, Ghosh D, Dhara S, Ghosh S, Sengupta A, Bhattacharya S. The efficacy of local application of mitomycin c in reducing recurrence rate of keloid after surgery. Bengal J Otolaryngol Head Neck Surg. 2016;24(3):117-21. [DOI:10.47210/bjohns.2016.v24i3.88]
25. Gupta M, Narang T. Role of mitomycin C in reducing keloid recurrence: patient series and literature review. J Laryngol Otol. 2011;125(3):297-300. [DOI:10.1017/S0022215110002045]
26. Chi SG, Kim JY, Lee WJ, Lee SJ, Kim DW, Sohn MY, Kim GW, Kim MB, Kim BS. Ear keloids as a primary candidate for the application of mitomycin C after shave excision: in vivo and in vitro study. Dermatol Surg. 2011; 37(2):168-75. [DOI:10.1111/j.1524-4725.2010.01846.x]
27. Fruth K, Gouveris H, Kuelkens C, Mann WJ. Radiofrequency tissue volume reduction for treatment of auricle keloids. Laryngoscope. 2011;121(6):1233-6. [DOI:10.1002/lary.21782]
28. Trace AP, Enos CW, Mantel A, Harvey VM. Keloids and Hypertrophic Scars: A Spectrum of Clinical Challenges. Am J Clin Dermatol. 2016;17(3):201-23. [DOI:10.1007/s40257-016-0175-7]
29. Roques C, Téot L. The use of corticosteroids to treat keloids: a review. Int J Low Extrem Wounds. 2008; 7(3):137-45. [DOI:10.1177/1534734608320786]
30. Liu XG, Zhang D. Evaluation of Efficacy of Corticosteroid and Corticosteroid Combined with Botulinum Toxin Type A in the Treatment of Keloid and Hypertrophic Scars: A Meta-Analysis. Aesthetic Plast Surg. 2021;45(6):3037-3044. [DOI:10.1007/s00266-021-02426-w]
31. Seo SH, Sung HW. Treatment of keloids and hypertrophic scars using topical and intralesional mitomycin C. J Eur Acad Dermatol Venereol. 2012; 26(5):634-8. [DOI:10.1111/j.1468-3083.2011.04140.x]
32. Mandour Y, Bake H, Mofty E, Ramadan E, Gomaa M, Akl E, Elrefae A. Topical versus interlesional mitomycin C in auricular keloids. Acta Otorrinolaringol Esp (Engl Ed). 2021; 72(5):280-287. [DOI:10.1016/j.otorri.2020.06.005]
33. Sanders KW, Gage-White L, Stucker FJ. Topical mitomycin C in the prevention of keloid scar recurrence. Arch Facial Plast Surg. 2005; 7(3):172-5. [DOI:10.1001/archfaci.7.3.172]
34. Stewart IV CE, Kim JY. Application of mitomycin-C for head and neck keloids. Otolaryngol Head Neck Surg. 2006;135(6):946-50. [DOI:10.1016/j.otohns.2005.07.026]
35. Simman R, Alani H, Williams F. Effect of mitomycin C on keloid fibroblasts: an in vitro study. Ann Plast Surg 2003;50:71-6. doi: 10.1097/00000637-200301000-00012. [DOI:10.1097/00000637-200301000-00012]
36. Sewall GK, Robertson KM, Connor NP, Heisey DM, Hartig GK. Effect of topical mitomycin on skin wound contraction. Archives of facial plastic surgery. 2003;5(1):59-62. [DOI:10.1001/archfaci.5.1.59]
37. Talmi YP, Orenstein A, Wolf M, Kronenberg J. Use of mitomycin C for treatment of keloid: a preliminary report. Otolaryngol Head Neck Surg 2005;132:598-601. doi: 10.1016/j.otohns.2004.09.060. [DOI:10.1016/j.otohns.2004.09.060]
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