DefinePK

Research Objective

To compare the efficacy of triamcinolone acetonide alone and triamcinolone acetonide plus 5-florouracil for treating keloids and hypertrophic scars in burn patients.

Methodology

A randomized controlled trial was conducted with 90 patients divided into two groups: Group A (triamcinolone acetonide alone) and Group B (5-fluorouracil + triamcinolone acetonide). Treatments were administered via intralesional injection every two weeks for a maximum of six sessions. Efficacy was compared using the Vancouver Scar Scale (VSS) and a pruritus scale after four weeks of treatment completion.

Methodology Flowchart

                        graph TD;
    A["Patient Recruitment"] --> B["Divide into Groups"];
    B --> C["Group A: TCA Alone Treatment"];
    B --> D["Group B: 5FU + TCA Treatment"];
    C --> E["Intralesional Injection TCA"];
    D --> F["Intralesional Injection 5FU + TCA"];
    E --> G["Assess VSS and Pruritus Scale"];
    F --> G;
    G --> H["Data Analysis"];
    H --> I["Conclusion"];                    

Discussion

The study supports previous findings that combination therapy of triamcinolone acetonide and 5-fluorouracil is more efficacious than triamcinolone acetonide alone for treating keloids and hypertrophic scars. While the combination therapy offers better outcomes, precautions are necessary due to potential complications like necrosis and ulceration if injected superficially.

Key Findings

The combination therapy (5-FU + TCA) showed a significantly higher improvement in Vancouver Scar Scale (VSS) scores (75.07%) compared to triamcinolone acetonide alone (65.80%), with a p-value of 0.047. The mean number of sessions required for at least 50% VSS reduction was also significantly lower in the combination group (3.31 sessions) compared to the TCA alone group (4.51 sessions) (p=0.032). Pruritus scale improvement was statistically insignificant between the groups.

Conclusion

Combination therapy of intra-lesion injection of triamcinolone acetonide and 5-florouracil has significantly higher efficacy compared to triamcinolone acetonide alone for the treatment of keloids and hypertrophic scars. For resistant or recurrent scars, combination therapy can be considered as a first-line treatment, with careful attention to injection technique to minimize complications.

Fact Check

* Sample Size: The study enrolled a total of 90 cases, with 45 in each group.
* VSS Improvement: Group A (TCA alone) showed 65.80% improvement, while Group B (5FU+TCA) showed 75.07% improvement.
* Statistical Significance: The difference in VSS improvement between the groups was statistically significant with a p-value of 0.047.

Mind Map