Efficacy and safety of verapamil vs triamcinolone acetonide for keloids and hypertrophic scars: A systematic review and meta‐analysis

2020 ◽  
Vol 33 (4) ◽  
Author(s):  
Ruiquan Liu ◽  
Bin Yang ◽  
Zhu Deng ◽  
Liu Liu ◽  
Xian Zhao
Keyword(s):  
Systematic Review ◽  
Triamcinolone Acetonide ◽  
Meta Analysis ◽  
Hypertrophic Scars ◽  
Efficacy And Safety

Comparing the Efficacy and Safety of Intralesional Verapamil With Intralesional Triamcinolone Acetonide in Treatment of Hypertrophic Scars and Keloids: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Pu Wang ◽  
Luosha Gu ◽  
Hongsen Bi ◽  
Qifei Wang ◽  
Zelian Qin
Keyword(s):  
Adverse Effects ◽  
Randomized Controlled Trials ◽  
Triamcinolone Acetonide ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Hypertrophic Scars ◽  
Efficacy And Safety ◽  
Skin Atrophy ◽  
Randomized Controlled ◽  
First Session

Abstract Background Clinical treatment of hypertrophic scars (HS) and keloids is often unsatisfactory. Intralesional injections of triamcinolone acetonide (TAC) and verapamil are widely used to treat HS and keloids, but their efficacy and safety are controversial. Objectives: To conduct a meta-analysis of the effectiveness and safety of verapamil and TAC in the treatment of HS and keloids. Methods Embase, Google Scholar, and PubMed were searched for randomized controlled trials (RCTs) from inception to February 2020. RCTs that evaluated treatment effects with the Vancouver Scar Scale or reported adverse effects were included. The continuous data and the dichotomous variables were analyzed as mean difference (MD) and relative risk (RR), respectively. Results Seven RCTs (461 patients) were included. Compared to baseline, TAC rapidly changed the △height (MD=0.07; P<0.05) and △pliability (MD=0.23; P<0.05) after the first session, with no significant differences in the △height (after last session: MD=0.50; P=0.42), △pigmentation (after first session: MD=0.07; P=0.51, after last session: MD=-0.10; P=0.14), △vascularity(after first session: MD=-0.25; P=0.57, after last session: MD=-0.02; P=0.79) and △pliability (after last session MD=0.52; P=0.48). Although total adverse effects (RR=0.42; P=0.1) were not significantly different, in the subgroup analysis, the incidence of telangiectasia (RR=0.04; P<0.05) and skin atrophy (RR=0.10; P<0.05) but not pain (RR=1.27; P=0.77) was significantly lower with verapamil than with TAC. Conclusions Verapamil may be an effective substitute for TAC. Although total adverse effects did not change, the incidence of telangiectasia and skin atrophy was lower with verapamil than with TAC.

Efficacy and Safety of Botulinum Toxin Type A in Preventing Postoperative Scars and Improving the Cosmetic Appearance of Scars: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 24 (6) ◽  
pp. 608-618
Author(s):  
Wei Zhang ◽  
Xinyi Li ◽  
Xiaojing Li
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Adverse Events ◽  
Meta Analysis ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Hypertrophic Scars ◽  
Efficacy And Safety ◽  
Cosmetic Appearance ◽  
Scar Width

Background Scars with poor cosmesis that develop after wound healing may affect normal life. Objective To assess the efficacy and safety of botulinum toxin type A (BTXA) in preventing postoperative hypertrophic scars or keloids. Methods A systematic review was performed by searching the PubMed, Cochrane Library, and EMBASE databases from their inception date up to February 2020 for randomized controlled trials (RCTs) evaluating the efficacy of BTXA in preventing hypertrophic scars or keloids. The primary outcome measures included the Vancouver Scar Scale (VSS) score, Visual Analog Scale (VAS) score, scar width, patient satisfaction, and adverse events. Results Twelve RCTs involving 497 cases (372 patients) were included. The meta-analysis showed significant differences in the VAS score (weighted mean difference [WMD] = 1.31, 95% CI = 1.06 to 1.55, P < .00001), VSS score (WMD = −1.02, 95% CI = −1.72 to −0.32, P = .004), scar width (WMD = −0.18, 95% CI = −0.29 to −0.08, P = .0008), and patient satisfaction (relative risk = 1.25, 95% CI = 1.06-1.49, P = .01). Four studies reported trivial adverse events. Conclusions This meta-analysis showed that BTXA was more effective than the control treatment in preventing postoperative scars and improving the cosmetic appearance of facial scars for East Asians, and no serious adverse events were found during the follow-up period. However, there was insufficient evidence to support the use of BTXA for the prevention of scars in patients from other ethnic groups and regions or scars in non-facial areas.

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