Sufficient mesh polyhedral intralesional injection for treatment of keloids

J Cosmet Dermatol. 2023 Oct;22(10):2769-2773. doi: 10.1111/jocd.15790. Epub 2023 May 8.

Abstract

Background: The recurrence of keloids after intralesional injections is significant, and a review of the literature shows an inconsistent range of success rates. In this study, the modified medical proportion and intralesional injection method were intended to enhance the treatment effect.

Methods: Twenty patients completed the study. Regional block anesthesia (lidocaine, ropivacaine) was performed. Triamcinolone acetonide (40 mg/mL), 5-fluorouracil (25 mg/mL), and ropivacaine (7.5 mg/mL) were configured in a ratio of 2:1:4 and applied on the lesion by reticular injection (horizontal fan-shaped stratified and vertical shaking pressurized injection). The minimum volume of injection per square centimeter was approximately 3.5 mL. The outcome indicators were the Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS), treatment frequency.

Results: The patients had an 82% ± 7% average reduction in VSS scores and 89% ± 13% and 93% ± 10% reductions in VAS scores of pain and pruritus, respectively, after an average of 2.5 ± 0.7 injections administered within 1 year.

Conclusion: The sufficient mesh polyhedral intralesional injection can achieve excellent results for the treatment of keloid scars.

Keywords: fluorouracil; injections; intralesional; keloid; triamcinolone acetonide.

Publication types

  • Review

MeSH terms

  • Cicatrix, Hypertrophic* / etiology
  • Humans
  • Injections, Intralesional
  • Keloid* / pathology
  • Ropivacaine / therapeutic use
  • Surgical Mesh
  • Treatment Outcome

Substances

  • Ropivacaine