Role of Triamcinolone Acetonide in the Maturation of Scars

INTRODUCTION

The presence of a scar on our body often has a deep emotional significance. These can bear lifelong physical and psychological burdens on an individual. Scarless healing has been an eternal quest for surgeons and physicians alike. A large aspect of plastic surgery is the attempt to convert unsightly scars to more aesthetically pleasing scars or to reduce the burden of scars to the minimum. In addition to the surgical techniques, various allied therapies including microneedling, platelet-rich plasma injections, massage, pressure garments, silicone sheeting, onion extract, topical application and intralesional injections of steroids/antimetabolizes, and combinations of these modalities have all been tried on patients to achieve an aesthetically appealing scar.1–3 Among the various steroids injected intralesionally, triamcinolone acetonide has stood the test of time. The role of triamcinolone acetonide in the treatment of hypertrophic scars and keloids is well established, displaying scar atrophy with successive injections.4 However, no clear guidelines on its prophylactic use and dosage exist. No studies have been conducted to date to assess its effects on normal scar evolution. If intralesional injections result in scar atrophy, will a preemptive injection improve the aesthetic outcome of a scar? The present observational study aims to study the role of triamcinolone acetonide in the maturation of scars among patients projected to have a suture line. It also aimed to quantify the parameters of the maturation of scars in case (with injection triamcinolone) and control (without injection triamcinolone) groups by the Vancouver Scar Scale (VSS) and Stony Brook Scar Evaluation Scale (SBSES) and to formulate clinical guidelines based on the outcome of the study. MATERIALS AND METHODS This is a prospective, observational, cohort study conducted from December 2020 to January 2022. A total of Cosmetic Original artiCle Background: Surgeons have tried various measures to achieve a minimum and aesthetically appealing scars after wound healing at surgical sites. Various regimens have been recommended to minimize scars both intraoperatively and postoperatively. Our study aims to assess the outcome of the injection of triamcinolone acetonide used intraoperatively on a normal surgical suture line. Methods: This is a prospective, observational study of 21 patients (divided into test and control groups with a single scar at the same site) treated with or without injection of triamcinolone acetonide, and outcomes were assessed using Vancouver Scar Scale and Stony Brook Scar Evaluation Scale. Results: We found a significant difference (P > 0.05) between the median of vascularity, pigmentation, and total score on the Vancouver Scar Scale, whereas there was significant difference between height, color, and overall appearance according to the Stony Brook Scar Evaluation Scale between the test and the control group. We could not find a significant difference in outcome with varying, increasing doses of triamcinolone acetonide. Conclusion: A low dose of triamcinolone acetonide is an effective drug that tends to improve the outcome of a scar in terms of vascularity, pigmentation, height, and overall appearance of the postoperative surgical scar and helps in the maturation of a normal scar. (Plast Reconstr Surg Glob Open 2024; 12:e5966; doi: 10.1097/GOX.0000000000005966; Published online 15 July 2024.) Ranjit Bhosale, MS, MCh, DNB* Rakesh Dawar, MS, MCh† Raj Kumar Manas, MCh, DNB, MNAMS, Fellowship (Microsurgery)‡ From the *Plastic and Aesthetic Surgery, Sculpt Sublime, Mumbai, India; †Burn, Plastic, and Reconstructive Surgery, MGM Super Specialty Hospital, Indore, Madhya Pradesh, India; and ‡Department of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, India. Received for publication September 18, 2023; accepted May 17, 2024. The study was approved for ethical clearance by the Institute Ethical Committee, All India Institute of Medical Sciences, New Delhi, India. Ref. No. IECPG-249/24.06.2020, RT-03/23/23.12.2020. Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/GOX.0000000000005966

Visit for more details : https://acrobat.adobe.com/id/urn:aaid:sc:AP:7ec908cc-3e1f-4368-9291-8648d128a761