A Comparative Study of immediate intraoperative versus 1-Week postoperative steroid injection after auricular keloid excision
Keywords:
auricular keloid, keloid surgery, steroid injection, complicationsAbstract
The steroid injection after keloid surgery reduces risk of keloid recurrence compared with keloid surgery alone. The steroid injection could perform immediately after surgery and 1-week post operation. No study compared results and complications between these timings. This study was a retrospective comparative study based on medical records between June 2021 and December 2022. A total of 20 patients who met the inclusion and exclusion criteria were enrolled and divided into two groups of 10 patients each: those who received intralesional steroid injection immediately after auricular keloid excision in the operating room and those who received steroid injection 1 week postoperatively. Data collection tools included forms for general patient information and clinical data. The results showed that patients who received immediate postoperative steroid injection had a 1.25-fold higher rate of recurrent erythematous hypertrophic scarring requiring additional steroid injections at 1, 2, and 3 months, and a 10% higher incidence of postoperative complications at 1 week. However, they had lower rates of postoperative complications at 1, 2, and 3 months by 10% and 20%, respectively. These differences were not statistically significant when compared with patients who received steroid injection 1 week after surgery. The result found intraoperative steroid injections after auricular keloid surgery increase risk of keloid recurrence needs additional steroid injection 1.25 times at 1-month, 2-month and 3-month post operation and increases risk of 1-week complication 10%. But decrease risk of 1-month, 2-month, 3-month complication 10-20%, not statistically significant, compared with 1-week postoperative steroid injection group. Conclusion that steroid injection after auricular keloid surgery could perform intraoperative and 1-week postoperative. No statistically significant keloid recurrence and complications between two groups.
References
Hao YH, Xing XJ, Zhao ZG, Xie F, Hao T, Yang Y, et al. A multimodal therapeutic approach improves the clinical outcome of auricular keloid patients. Int J Dermatol. 2019;58(6):745-9.
Bermueller C, Rettinger G, Keck T. Auricular keloids: treatment and results. Eur Arch Otorhinolaryngol. 2010;267(4):575-80.
Hung YT, Lin SM, Tzeng IS, Ng CY. Optimizing surgical outcome of auricular keloid with a novel multimodal approach. Sci Rep. 2022 Mar 3;12(1):3533. doi: 10.1038/s41598-022-07255-8. PMID: 35241718; PMCID: PMC8894473.
Shin JY, Lee JW, Roh SG, Lee NH, Yang KM. A Comparison of the Effectiveness of Triamcinolone and Radiation Therapy for Ear Keloids after Surgical Excision: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2016;137(6):1718-25.
Wesley CK, Teo LH, Xu T, Unger RH, Unger WP. The influence of peri-incisional triamcinolone acetonide injection on wound edge apposition. J Dermatolog Treat. 2014;25(4):345-9.
Gold DA, Sheinin R, Jacobsen G, Jones LR, Ozog DM. The Effects of Postoperative Intralesional Corticosteroids in the Prevention of Recurrent Earlobe Keloids: A Multispecialty Retrospective Review. Dermatol Surg. 2018;44(6):865-9.
Bashir MM, Ahmad H, Yousaf N, Khan FA. Comparison of single intra operative versus an intra operative and two post operative injections of the triamcinolone after wedge excision of keloids of helix. J Pak Med Assoc. 2015;65(7):737-41.
Rosen DJ, Patel MK, Freeman K, Weiss PR. A primary protocol for the management of ear keloids: results of excision combined with intraoperative and postoperative steroid injections. Plast Reconstr Surg. 2007;120(5):1395-400.
Choi YJ, Lee YH, Lee HJ, Lee GY, Kim WS. Auricular keloid management in Asian skin: Clinical outcome of intralesional excision and postoperative triamcinolone acetonide intralesional injection. J Cosmet Dermatol. 2020;19(11):3041-7.
Mohammadi AA, Kardeh S, Motazedian GR, Soheil S. Management of Ear Keloids Using Surgical Excision Combined with Postoperative Steroid Injections. World J Plast Surg. 2019;8(3):338-44.
Jung JY, Roh MR, Kwon YS, Chung KY. Surgery and perioperative intralesional corticosteroid injection for treating earlobe keloids: a korean experience. Ann Dermatol. 2009;21(3):221-5.
Donkor P. Head and neck keloid: treatment by core excision and delayed intralesional injection of steroid. J Oral Maxillofac Surg. 2007;65(7):1292-6.
Jaruniphakul K, Awsakulsutthi S, Kitvoraphat K, Saengpongpithaya T, Singnoo A. Outcome of piercing auricular keloid after surgical excision by through-and-through technique and adjuvant triamcinolone acetonide injection. Asian Med J Altern Med. 2021;21(3):210-9.
Information Center, Kalasin Hospital. Surgical Department Patient Statistics. Kalasin: Kalasin Hospital; 2021.
Burusapat C, Wanichjaroen N, Wongprakob N, Sapruangthong R. The Effectiveness of Immediate Triamcinolone Acetonide Injection after Auricular Keloid Surgery: A Prospective Randomized Controlled Trial. Plast Reconstr Surg Glob Open. 2021 Aug 4;9(8): e3729. doi: 10.1097/GOX.0000000000003729. PMID: 34367855; PMCID: PMC8337065.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Khonkaen Public Health Provincial Office
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของสำนักงานสาธารณสุขจังหวัดขอนแก่น กระทรวงสาธารณสุข
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับสำนักงานสาธารณสุขจังหวัดขอนแก่น และบุคลากรท่านอื่นๆในสำนักงานฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใดๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
