Comparison of the efficacy and safety of intralesional triamcinolone injection with the combination of triamcinolone, five fluorouracil, and hyluronidase enzyme in the treatment of keloids and hypertrophic scars

Abstract

Hypertrophic and keloids scars are frequent benign disorders. These disorders occur due to the deposition of aberrant collagen in the scar tissue and can cause significant clinical presentations such as itching, discomfort, and disfigurement. Many therapeutic approaches have been proposed for their treatment without any acceptable outcomes. Methods After receiving ethical committee approval, a randomized prospective control trial was done in the clinic of plastic surgery at Suez Canal University Hospital for 3 months, from June 2023 to September 2023. 30 patients of both sexes and above the age of 14 were enrolled in the study and classified into two equal groups of 15 each: group (A) patients injected with triamcinolone alone, and group (B) patients injected with the combined therapy. All lesions were evaluated at 4, 8, and 12 weeks of injection. Scars were evaluated by the patient and observer scar assessment scale (POSAS) score. Complications such as atrophy of the skin, superficial ulcers, and telangiectasia have also been reported during or after injection. Results At 12 weeks of injection, both doctors and patients gave remarkably lower patient and observer scar assessment scale scores compared with those before injection, and there was a statistically significant difference between both groups. Group (B) scars improved more than group (A) scars in terms of itching, discomfort, pain, movement limitation, and aesthetic concern. Recurrence occurred only in group (A) patients. Conclusion The injection of the combined solution is effective more than triamcinolone alone. It results in a faster response, and an acceptable aesthetic outcome with few adverse effects.