Comparative efficacy of intralesional triamcinolone acetonide injection during early and static stage of pathological scarring

Song, Huapei; Tan, Jianglin; Fu, Qingqing; Huang, Ling; Ao, Ming

doi:10.1111/jocd.12690

Cited by 23 publications

(16 citation statements)

References 23 publications

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“…However, various laser therapies have recently been shown to improve the appearance of surgical scars by early intervention within 1 week after the removal of sutures [11]. Normally, the early stage for burn scars is 3–6 months after injury, while the static stage for burn scars is more than 6 months after injury [12]. The traditional recommendation has been to start laser treatment 3–6 months after scar formation.…”

Section: Discussionmentioning

confidence: 99%

Hypertrophic Scar Improvement by Early Intervention With Ablative Fractional Carbon Dioxide Laser Treatment

et al. 2020

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Background and Objectives Ablative fractional laser treatment has been used to improve the color and texture of hypertrophic scars with safe and effective results. However, no consensus on the optimal time to initiate fractional laser treatment is available. The effect on early‐stage scars remains controversial. This study was designed to assess the efficacy and safety of ablative fractional carbon dioxide (CO2) laser treatments for hypertrophic burn scars and to analyze the efficacy and safety in the early period within 3 months after injury. Study Design/Materials and Methods We performed a retrospective study of 221 hypertrophic scar patients. According to the time of the first laser treatment after injury, patients were divided into five subgroups, including less than 1 month, 1–3 months, 3–6 months, 6–12 months, and more than 12 months postinjury. One month after the last laser treatment, the scars were assessed by photography, the Vancouver Scar Scale (VSS), durometry, and spectrocolorimetry. Results The patients included 118 males and 103 females. The average age was 33.6 years. Fire/flame was the primary injury source. Thirty‐six percent of the patients underwent at least one fractional CO2 laser treatment. All the included patients, including those treated within 1 month after injury, had significantly decreased VSS scores after laser treatment. We also noted that hardness and redness scores were decreased after treatment for both scars treated within 3 months and those treated more than 12 months after injury. Seepage (17.6%), bleeding (22.2%), and swelling (9.0%) were the main adverse events after laser treatment. Conclusions This study demonstrated the safety and efficacy of ablative fractional CO2 laser treatment applied to early‐stage burn scars. The optimal time for laser application for burn patients can be within 1 month after injury. Durometry and spectrocolorimetry were effective for assessing scars as objective modalities. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

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Section: Discussionmentioning

confidence: 99%

Hypertrophic Scar Improvement by Early Intervention With Ablative Fractional Carbon Dioxide Laser Treatment

et al. 2020

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“…Scars are the products of wound healing by the human body. Among them, hypertrophic scars (HS) and keloids are known as pathological scars, which are characterized by sustained hyperactive growth, irregular scar shape, and an uneven and tough texture (1). Pathological scars are the result of hypertrophy of scar tissue in the process of tissue repair following trauma.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of USP4 attenuates pathological scarring by downregulation of the TGF‑β/Smad signaling pathway

Zhang

Pan

et al. 2019

Mol Med Report

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Pathological scarring is a result of the hypertrophy of scar tissue during tissue repair following trauma. The aim of the present study was to assess the effect of ubiquitin-specific protease 4 (uSP4) silencing on pathological scarring, and to evaluate the mechanistic basis for the effect. an MTT assay was used to assess cell viability. immunoprecipitation (iP) was used to determine ubiquitination levels of the TGF-β receptor (Tβr)i and Smad7. Tumor formation was assessed by injecting keloid fibroblasts. Hematoxylin and eosin staining was used to detect pathological changes in tumor tissue. reverse transcription quantitative polymerase chain reaction and western blot analysis assays were used to evaluate the expression levels of Tβri and Smad7. compared with the untreated control animals, cell viability and the expression of Tβri and Smad7 increased significantly in animals treated with TGF-β. Short hairpin rna for uSP4 (shuSP4) decreased the cell viability of negative control cells, TGF-β-induced cellular proliferation, and the expression of TβRI and Smad7. IP experiments indicated that the ubiquitination level of Tβri was decreased following uSP4 silencing. There was no remarkable difference in the structure of scar tissue among the various animal groups at 14 days following treatment, while the necrotic area of the scar tissue in the shuSP4 and vialinin a (uSP inhibitor)-treated animals increased significantly at the 28th and 42nd day compared with the control animals. At days 14, 28 and 42, the expression levels of Tβri and Smad7 in the shuSP4 and vialinin a-treated animals were significantly decreased compared with the control animals (P<0.05). in summary, interference with or inhibition of uSP4 prevented the activity of the TGF-β/Smad pathway signaling and inhibited the formation of pathological scars.

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“…These are high success rates, without the increased risk of adverse events or the added expense of additional agents. Our technique of initial balloon dilation under direct vision, as previously described, creates a safe tract to then atraumatically pass the resectoscope, empty the bladder, and evaluate the bladder and ureteral orifices prior to TUIBNC [ 16 ]. For many anterior urethral strictures, this initial dilation may be all that is needed to maintain patency.…”

Section: Discussionmentioning

confidence: 99%

Transurethral Incisions for Bladder Neck Contracture: Comparable Results without Intralesional Injections

Nealon¹,

Bhanvadia²,

Badkhshan³

et al. 2022

JCM

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To present our 12-year experience using an endoscopic approach to manage bladder neck contracture (BNC) without adjunctive intralesional agents and compare it to published series not incorporating them, we retrospectively reviewed 123 patients treated for BNC from 2008 to 2020. All underwent 24 Fr balloon dilation followed by transurethral incision of BNC (TUIBNC) with deep incisions at 3 and 9 o’clock using a Collins knife without the use of intralesional injections. Success was defined as a patent bladder neck and 16 Fr cystoscope passage into the bladder two months later. Most with recurrent BNC underwent repeat TUIBNC. Success rates, demographics, and BNC characteristics were analyzed. The etiology of BNC in our cohort was most commonly radical prostatectomy with or without radiation (36/123, 29.3%, 40/123, 32.5%). Some had BNC treatment prior to referral (30/123, 24.4%). At 12-month follow-up, bladder neck patency was observed in 101/123 (82.1%) after one TUIBNC. An additional 15 patients (116/123, 94.3%) had success after two TUIBNCs. On univariate and multivariate analyses, ≥2 endoscopic treatments was the only factor associated with failure. TUIBNC via balloon dilation and deep bilateral incisions without the use of adjunctive intralesional injections has a high patency rate. History of two or more prior endoscopic procedures is associated with failure.

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Comparative efficacy of intralesional triamcinolone acetonide injection during early and static stage of pathological scarring

Cited by 23 publications

References 23 publications

Hypertrophic Scar Improvement by Early Intervention With Ablative Fractional Carbon Dioxide Laser Treatment

Hypertrophic Scar Improvement by Early Intervention With Ablative Fractional Carbon Dioxide Laser Treatment

Inhibition of USP4 attenuates pathological scarring by downregulation of the TGF‑β/Smad signaling pathway

Transurethral Incisions for Bladder Neck Contracture: Comparable Results without Intralesional Injections

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