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COMPARISON OF DIFFERENT MODALITIES OF TREATMENT OF HYPERTROPHIC SCARS AND KELOIDS

Doctor Quddus-ur-Rehman

MBBS, FCPS (Surgery)

Associate Teacher of Physiology

Aziz Fatimah Medical and Dental University, Faisalabad.

Doctor Usman Latif, MBBS, FCPS, MCPS

Connect professor of anatomy

Sharif medical college or university, Lahore

Dr . Anwar Saood Saqib

MBBS, DMJ

Brain of Department Forensic Remedies,

Aziz Fatimah Medical and Dental College, Faisalabad.

Doctor Asim Elahi

Demonstrator

Aziz Fatimah Medical and Dental School, Faisalabad.

Intended for Correspondence:

Doctor Quddus-ur-Rehman

Relate Professor of Anatomy

Aziz Fatimah Dental and medical College, Faisalabad.

Email: [email protected] com

Ph #: 03336517421

Abstract

Launch Hypertrophic scarring and keloids are severe overgrowth of scar tissue that result from a great abnormal conjoining tissue response to trauma, swelling, surgery, burns and occasionally manage to occur spontaneously. Aims and objectives-To enhance the cosmesis and symptomatology of patients, to compare the results of various modalities of treatment of hypertrophic scars and keloids also to find out one of the most workable strategy towards the issue. Study design: Prospective randomized clinical trial with response adaptive randomization. Place and duration of examine: It was carried out in Sibling hospital, Punjab Medical College or university, Faisalabad coming from April 2009 to Sept 2011. Supplies and strategies: In this examine 72 individuals were studied. Most of these patients were cared for on outdoor basis while some of them were admitted in wards for surgical and other treatments. We registered each one of these patients to get our analyze and in depth history and physical examination had been carried out and applied different choices of treatments in different individuals and adopted them up. Inclusion standards: All those sufferers were included in our research that came to outpatient office of Germane Hospital, Faisalabad with Hypertrophic scars and keloids. Exemption criteria: Dozens of patients unwilling for treatment had been excluded from your study. Benefits: In our analyze of 72 patients of hypertrophic marks and keloids, 29 were males and 43 had been females. Out of seventy two patients 33 patients had been having keloids while 39 patients had been suffering from hypertrophic scars. 25 (34. 72%) patients got tender marks while 47 (65. 27%) had low tender lesions. 4 (5. 55%) away of seventy two patients had neck contracture associated with hypertrophic scars causing functional problems. 21 (29. 16%) out of 72 patients had psychological problems because of their lesions. Out of 72 people, 40 (55. 55%) experienced mild, 10 (15. 27%) had moderate and 21 (29. 16%) patients had severe beauty problems. There was clearly 20 % recurrence charge in intralesional injections of steroid, 30 % in silicone gel sheeting, 25 % in surgery and postoperative intralesional injection, 60 % in the case of surgery and postoperative irradiation and twenty % in surgery by itself in addition to other complications. In case of intralesional injections of triamcinolone acetonide 25 (62. 5%) away of forty five patients experienced excellent benefits. 6 (15%) patients had good results. 1 (2. 5%) patient experienced satisfactory and 8 (20%) patients got poor result. In silicon gel sheeting, out of 12 individuals 6 (50%) had excellent, 2 (16. 6%) good, 1 (8. 33%) adequate and a few patients had (25%) poor results. In those sufferers in to whom we put together surgery with steroid shots, 4 (50%) patients experienced excellent effects, 1 (12. 5%) individual had great outcomes, 1 (12. 5%) patient had sufficient and two (25%) sufferers had poor outcome. In 2 patients in which we put together surgery with radiotherapy 1 patient improved while the additional patient received recurrence. Following surgical excision of hypertrophic scars in 5 sufferers, 2 (40%) patients acquired excellent, a couple of (40%) great, and one particular (20%) sufferer had poor results. CONCLUSION: Intralesional injections of Triamcinolone Acetonide were safe, user friendly, economical, and acceptable for the patients and had good results concerning scar colour, texture,...

Referrals: 1 . Thorne-CH, Bartlett-SP Beasley RW, Aston SJ, Gurtner GC, spear SL. Injury Healing: Regular and Unnatural In: Grabb & Smith's Plastic Surgery. sixth edition. Phila. / Baltimore / Fresh York/ Birmingham: Lippincott Williams and Wilkins, 2007; 15-22.

2 . Ogawa, Rei; Akaishi, Satoshi; Izumi, Miki. Histologic Analysis of Keloids and Hypertrophic Marks. Ann-Plast-Surg. 2009 Jan; 62(1): 104-105.

several. Sadeghinia, A. and Sadeghinia, S. (2011), Comparison of the Efficacy of Intralesional Triamcinolone Acetonide and 5-Fluorouracil Needling for treating Keloids. Dermatologic Surgery. doi: В 10. 1111/j. 1524-4725. 2011. 02137.

four. Ogawa 3rd there’s r (February 2010). В " The most current algorithms to get the treatment and prevention of hypertrophic scars and keloids". В Plast. Reconstr. Surg. В 125В (2): 557–68. doi: 10. 1097/PRS. 0b013e3181c82dd5. В PMIDВ 20124841.

5. Rapini, Ronald G.; Bolognia, Blue jean L.; Jorizzo, Joseph D. (2007). В Dermatology: 2-Volume Set. St . Louis: Mosby. pp. В 1499. В ISBNВ 1-4160-2999-0.

6. Leventhal D, Furr  M, Reiter  D.  Treatment of keloids and hypertrophic scars.  Arch Facial Plast Surg.  2006; 8(6): 362–368.

7. Juckett G, Hartman-Adams H. Managing of keloids and hypertrophic scars. I am Fam Medical professional. 2009 Aug 1; 80(3): 253-60.

8

9. Robles DT, Berg G. Abnormal wound healing: keloids.  Clin Dermatol.  2007; 25: 26–32.

twelve. Atiyeh BULL CRAP. non-surgical managing of hypertrophic scars: evidence-based therapies, standard practices, and emerging methods.  Aesthetic Plast Surg.  2007; 31: 468–94.

11. Boutli-Kasapidou F, Tsakiri A, Anagnostou E, Mourellou O. Hypertrophic and keloidal scars: an approach to polytherapy.  Int J Dermatol.  2005; forty-four: 324–7.

13. Berman B, Amini S, Viera M, Valins W. Keloid and Hypertrophic Scar. eMedicine coming from WebMD. Offered at: http://www.emedicine.com/derm/topic205.htm. Reached November 15, 2010.

18. DuraniВ P, В BayatВ A. В (2008)В LevelsВ ofВ evidence forВ theВ treatmentВ ofВ keloid disease.

sixteen. Jalali M, Bayat A. Current make use of steroids in management of irregular raised epidermis scars. Physician. 2007; five: 175-180.

17. Poochareon VN, В Berman M. В (2003) NewВ therapies forВ the managementВ of keloids. JВ Craniofac SurgВ 14: 654-657.

18. Jung JY, Roh MR, Kwon YS, Chung KY. Medical procedures and Perioperative Intralesional Corticosteroid Injection intended for Treating Earlobe Keloids: A Korean Experience. Ann Dermatol.  2009 Aug;  21(3): 221–225.

21. Um 'Brien M, Pandit A. Silicon gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst Rev. 2006 Jan25; (1): CD003826. Assessment. PubMed PMID: 16437463.

22. A handled clinical trial of topical cream silicone skin gels sheeting inside the treatment of hypertrophic scars and keloids. A dermatologic encounter. Gold MH. J Dermatol Surg Oncol. 1993 March; 19(10): 912-6.

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