Benefits of extracorporeal shock waves for keloid treatment: A pilot study

Abstract

Keloids are fibroproliferative skin disorders characterized by the progressive deposition of collagen. Recently, extracorporeal shock wave therapy (ESWT) has been used to treat pathologic scars. Herein, we conducted a study to compare the efficacy of intralesional injections (ILIs) of triamcinolone acetonide (TA) used alone, or in combination with ESWT for keloids. Forty patients were randomized equally into two groups in this 12‐week comparative clinical trial. Group A was treated with TA ILIs and ESWT, and group B was treated with TA ILIs alone. At week 12, both groups showed acceptable improvements in nearly all dimensions evaluated, and these improvements were statistically more significant in group A. Group A showed a higher mean percentage reduction in lesion length, width, and height and in the Vancouver Scar Scale score than group B (all P < .05). More patients in group A than in group B had scores of ≥4, which indicated improvements that were good or excellent, on the patient global assessment and investigator global assessment. No serious adverse events occurred. This study suggests that ESWT could be a new, effective and acceptable adjuvant treatment option for keloids.

Possible mechanism of static progressive stretching combined with extracorporeal shock wave therapy in reducing knee joint contracture in rats based on MAPK/ERK pathway

“…It is also a safe and effective non-invasive treatment for many fibrotic diseases such as myogenic contracture, pathological scars, epidural fibrosis, etc. [13][14][15][16][17][18][19][20]. In this study, extension knee joint contracture in rats was treated in different ways, to explore whether the treatment effect of SPS combined with ESWT is better than single treatment, and to guide clinical practice.…”

“…Extracorporeal shock wave therapy (ESWT) is widely used in musculoskeletal system diseases [ 13 , 14 ]. The mechanical stimulation produced by ESWT has biochemical effects on some cells and affects the cell cycle and metabolic pathways, which can regulate the migration, proliferation, differentiation and apoptosis of fibroblasts, endothelial cells, osteoblasts, and tenocytes [ 15 ]. Relevant studies have shown that ESWT can reduce cell migration and effectively inhibit the expression of TGF-β1, alpha smooth muscle actin (α-SMA), type I collagen, and fibronectin [ 16 ], making it a feasible and cost-effective method for the treatment of pathological scars after burns [ 17 ].…”

Mechanomodulation: Physical Treatment Modalities Employ Mechanotransduction to Improve Scarring

“…Another study compared the efficacy of Triamcinolon Acetonide injections (TAI) alone, or in combination with SWT, to treat keloids. The SWT group showed significantly greater good to excellent improvements in the patient and observer global assessment [86]. Aguilera-Saëz et al [87] found no significant differences in any of the Vancouver Scar Scale variables, comparing a group of burn patients treated with standard of care with a group additionally treated with SWT.…”

Safety and efficacy of treating post‐burn pathological scars with extracorporeal shock wave therapy: A meta‐analysis of randomised controlled trials

“…23 More recently, a series of clinical studies of ESWT on pathological scars concluded the positive effects of ESWT on scars with different etiologies. 20,[24][25][26][27][28][29][30][31][32][33][34][35][36] A synthesis of existing evidence of human clinical trials may provide more insight into ESWT application. However, no systematic review and meta-analysis of the effects of ESWT on PBPS has been published yet.…”

“…Taheri et al found effects of ESWT on improving PBPS in extremities with a prospective quasi‐experimental study and reported that ESWT could improve pain, itching and appearance of the PBPS 23 . More recently, a series of clinical studies of ESWT on pathological scars concluded the positive effects of ESWT on scars with different etiologies 20,24–36 …”