Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kafka, M.
Treatments for Hypertrophic Scars: a Systematic Review
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2016. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Kamolz Lars-Peter
- Wurzer Paul
- Altmetrics:
- Abstract:
- Background: Up to now, there are many treatment modalities for hypertrophic scars available. However, there is no standard treatment protocol for the therapy of hypertrophic scarring. Thus, we performed a systematic review to validate treatment regimens according to their evidence and to further summarize currently used invasive and non-invasive treatment strategies for hypertrophic scars. Methods: The study protocol was reviewed and registered on PROSPERO (CRD42015027040). PubMed and Web of Science were screened in October 2015 by using predefined MeSH-Terms. A collection of all available clinical trials regarding to our topic was created and all results were pooled into one Excel spreadsheet. Afterwards, systematic analysis and screening of full-text articles was performed. Finally, all studies which met the inclusion criteria were evaluated and graded, according to their level of evidence. Studies which achieved a level of evidence I were compared. Results: After the primary literature research we obtained a total number of 1,029 search results. At the end of the systematic review, we ended up with 6 clinical trials, which we could include into this further systematic analysis. The included studies investigated the effects of silicone products, pressure garment therapy, intralesional injections of Triamcinolone, 5-Fluorouracil with Triamcinolone and the irradiation of 585nm Pulsed-Dye laser added to the injections of 5-Fluorouracil with Triamcinolone. According to the results, both, injection treatments and also the supplementary irradiation with the Pulsed-Dye laser, achieved good treatment results. In case of the use of silicone products alone, the evidence is lacking. However, a combination of silicone gel sheets and pressure garments gained the best results in the non-invasive treatment group. Discussion and Conclusions: Our systematic review showed that there is still lack of prospective randomized controlled trials for the treatment of hypertrophic scars. With respect to the 6 included clinical trials, the application of intralesional 5-Flourouracil in combination with a low dosage of Triamcinolone can be recommended as treatment modality. This therapy achieved good scar improvement referring to scar height, thickness, erythema and pigmentation. This combined treatment option showed better results compared to the injection of Triamcinolone alone, and the occurring side effects were lower in a statistically significant way as well. The addition of irradiation intervals to this combination therapy, using a 585nm Pulsed-Dye laser, showed promising results too and should therefore be kept in mind. Certainly, the combination of silicone gel dressings with pressure garments seems to have the best impact as a treatment for hypertrophic scars in the group of non-invasive treatment options and therefore should be considered in cases were a minimally invasive treatment is needed.