Painless steroid injections for hypertrophic scars and keloids

Azad, S.; Sacks, L.

doi:10.1054/bjps.2002.3913

Cited by 11 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Besides, larger lesions have higher malignant potential, and reconstruction of a sizeable facial lesion is a complex endeavor. 1,2 The potential donor sites, the function of facial units, and facial contour must be carefully considered in the restoration of facial lesions. 3 The cheek and forehead, which border the eye, nose, lips, chin, and ear provide the architecture for facial expression, mastication, deglutition, and speech.…”

Section: Discussionmentioning

confidence: 99%

“…Local infiltration anesthesia before intralesional corticosteroid injection into keloids is a good treatment option for local anesthesia. 1 On the other hand, topical lidocaine-/prilocaine (EMLA) cream before intralesional corticosteroid administration in keloids can also be considered to reduce needle puncture pain. Until now, there has yet to be a report on which local anesthetic technique is superior in keloid treatment.…”

Section: Topical Anesthetic Versus Lidocaine Mixture For Pain Relief ...mentioning

confidence: 99%

See 1 more Smart Citation

Topical Anesthetic versus Lidocaine Mixture for Pain Relief During Keloid Treatment: A Prospective, Split Study

Park

2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Background: The most common typical symptoms of keloids can be pain and itchiness. Intralesional corticosteroid administration is generally the first-line conservative treatment. Minimizing pain during intralesional corticosteroid injections into keloids should be aimed, as the treatment is often painful. There has yet to be a report on which local anesthetic technique is superior in keloid treatment between topical anesthetic versus lidocaine mixture injection. Methods: This was a single-center prospective study. The study included 100 patients with painful multiple/multifocal keloids aged 18 to 85 years and was performed between May 2021 and December 2022. Among multiple keloid lesions in a single patient, we assigned the keloids pretreated with topical cream application versus local injection. Then, subjects received 40 mg of intralesional corticosteroid injections into the keloids with a 26G needle to treat keloids. Patients rated the pain intensity of each lesion pretreated with two different anesthetic techniques on an 11-point numeric rating scale. A separate direct question of “Which technique would you recommend if you had to be injected again?” was given. Results: One-hundred patients with painful multiple/multifocal keloids were included in the study. Data on pain intensity numeric rating scale (NRS) revealed that injection techniques relieved the pain statistically significantly more than topical creams. (P<0.001) 63% of the participants (n=63) preferred the injection technique, while 25% preferred topical anesthetics. In total, 12% of patients responded that there was no difference between the two techniques. Conclusion: When comparing with topical lidocaine/prilocaine (EMLA) cream, a 1:1 mixture of 1% lidocaine and epinephrine significantly alleviated pain during and after the corticosteroid injection.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Topical Anesthetic Versus Lidocaine Mixture For Pain Relief ...mentioning

confidence: 99%

Topical Anesthetic versus Lidocaine Mixture for Pain Relief During Keloid Treatment: A Prospective, Split Study

Park

2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

show abstract

“…Both patients and practitioners desire minimal scarring after wound closure 16 . Several methods have been used to treat hypertrophic scars including scar massage; 17 application of local pressure 18 (pressure garments, conformers, transparent face masks, casts, or splints); use of silicone materials 19 (with or without pressure); intralesional injection of corticosteroids, interferon or retinoids; 20–22 and surgery. While these methods have been somewhat successful, there is no currently available therapy that minimizes scarring in “normal” or routine scars that result from lacerations or elective incisions.…”

Section: Discussionmentioning

confidence: 99%

Development of a porcine incisional wound model and novel scarring scales

Singer

McClain

2006

Wound Repair Regeneration

View full text Add to dashboard Cite

A major goal of wound management is to reduce scarring. Prior to evaluating novel anti-scarring therapies, we developed a porcine incisional wound model and scarring outcome measures. Forty-eight full-thickness incisions (3 cm in length) and excisional wounds (3 x 0.5 cm) were created on two animals and closed with sutures (n=24) or tissue adhesive (n=24). Scars were evaluated using two validated clinical scar scales and a novel scale developed for animals. Full-thickness biopsies were obtained at 5 and 8 weeks for determination of scar morphology using H&E and Congo red staining with and without polarized light. Scar tissue was classified based on the collagen fiber morphology and "redness" ratio, which is a measure of the relative distribution of collagen fiber in all three spatial dimensions. The clinical cosmetic scales were highly reliable, yet nondiscriminatory. The novel gross cosmetic and histomorphological scores were both highly reliable (0.75 and 0.70, respectively), yet poorly correlated with each other (0.17). The "redness" ratio and cross-sectional surface area measurements were also highly reliable (r=0.96 and 0.99, respectively) but unrelated to cosmetic outcomes. However, the "redness ratio" did correlate with the histomorphologic appearance of the scars, with poorer appearing clinical scars receiving lower ratios (ANOVA p=0.001). Significant differences in cosmetic scores were noted between excisional and incisional wounds favoring incisions (p=0.0019). We describe a novel porcine model for incisional and excisional wounds. The new clinical and histomorphologic outcomes were highly reliable yet poorly correlated. In general, incisional wounds healed with less apparent scarring than excisional wounds.

show abstract

“…Azad e Sacks 6 propõem a aplicação tópica prévia de EMLA ® que produz anestesia cutânea que se estabelece entre 30 a 60 minutos, seguida da injeção perilesional de uma mistura de lidocaína e bupivacaína no início do procedimento. A associação de um anestésico local de curta e longa ação tem como objetivo proporcionar anestesia intraoperatória e analgesia pós-operatória, respectivamente.…”

Section: Infiltração De Cicatrizes Hipertróficas E Quelóidesunclassified

“…A associação de um anestésico local de curta e longa ação tem como objetivo proporcionar anestesia intraoperatória e analgesia pós-operatória, respectivamente. 6 Estão já disponíveis dispositivos de contraestimulação que poderão vir a ter aplicação no controlo da dor neste contexto. …”

Section: Infiltração De Cicatrizes Hipertróficas E Quelóidesunclassified

Abordagem da Dor em Dermatologia (Parte II)

Duarte

Roberto

Cruz

et al. 2018

SPDV

View full text Add to dashboard Cite

RESUMO -A dor é um sintoma universal em Medicina; e na Dermatovenereologia é transversal ao seu domínio médico e cirúrgi-co. No domínio cirúrgico da especialidade temos a dor aguda peri-operatória, provavelmente mais frequente do que o esperado e cujo tratamento insuficiente implica morbilidade aguda e até potencialmente a longo prazo, dado o risco de cronificação. A dor crónica está associada a várias doenças cutâneas e é muitas vezes causa major de sofrimento para os doentes, dada a sua abordagem ser complexa, desafiante e por vezes infrutífera, agravada pela pouca evidência sobre como tratar apropriadamente o doente dermatológico com dor crónica. Este artigo é a segunda e última parte de uma revisão cujo objetivo é discutir os princípios gerais do tratamento da dor aguda peri--operatória e crónica no contexto da especialidade. Neste segundo capítulo será abordada a dor relacionada com procedimentos terapêuticos específicos. Por último, será discutida a dor crónica associada a entidades dermatológicas com quadros álgicos significativos. PALAVRAS-CHAVE - INTRODUÇÃOA dor é considerada o quinto sinal vital e o seu controlo é um indicador de qualidade dos serviços de saúde. Na primeira parte desta revisão, foi demonstrada a repercussão que a dor não controlada pode ter nas múltiplas esferas do domínio socioeconómico e familiar: sofrimento para os doentes e cuidadores, absentismo profissional, isolamento social e consumo significativo dos recursos de saúde. Observámos também que na Dermatologia e Venereologia, enquanto especialidade médico-cirúrgica, a dor não controlada é um sintoma frequentemente presente, quer por consequência de procedimentos cirúrgicos, quer devido a entidades clínicas com quadros fisiopatológicos complexos (como a úlcera de perna), e ao qual está associada uma perda major de qualidade de vida.Torna-se assim evidente a importância do tratamento eficaz da dor no doente dermatológico. Contudo, o controlo da dor, principalmente da dor crónica, continua a ser um desafio, havendo necessidade de delinear estratégias eficazes. A segunda parte deste artigo tem como objetivo colmatar esta necessidade, ao abordar o tratamento da dor aguda em procedimentos dermatológicos específicos e o tratamento da dor crónica associada a algumas entidades clínicas de gestão difícil.

show abstract

Painless steroid injections for hypertrophic scars and keloids

Cited by 11 publications

References 5 publications

Topical Anesthetic versus Lidocaine Mixture for Pain Relief During Keloid Treatment: A Prospective, Split Study

Topical Anesthetic versus Lidocaine Mixture for Pain Relief During Keloid Treatment: A Prospective, Split Study

Development of a porcine incisional wound model and novel scarring scales

Abordagem da Dor em Dermatologia (Parte II)

Contact Info

Product

Resources

About