Effectiveness of Cold Gel Compression Before Intralesional Triamcinolone Acetonide Injection for Pain Relief in Keloid Treatment

Abstract

Objective: This research aims to study effectiveness of cold gel compression before intralesional triamcinolone acetonide injection for pain relief in keloid treatment.

Materials and methods: A randomized cross-over study in the patients with keloid at out patient department of plastic surgery, Samutsakhon hospital between June 2009 to May 2011. Sixty four patients consented and then was devided into 2 groups. All of them received intralesional steroid injections for 2 times within 1 month apart. One time of treatment they had cold gel compression before intralesional steroid injections. Pain scores 0-10 were used to evaluate the patients’ feeling.

Results: Demographic data of both groups of the patients were not different in gender, age, location, size of keloid, amount of steroid used and side effect. Pain scores in the patients who received cold gel compression before steroid injection were lower both during puncture the needle and injection of steroid. Pain scores during puncture the needle were 3.09 ± 2.11 and 1.86 ± 1.93 in group that not received and received cold gel compression, respectively (p-value < 0.001). Pain scores during injection of steroid were 5.25 ± 2.59 and 2.36 ± 2.06 in group that not received and received cold gel compression, respectively (p-value < 0.001). Pain scores were divided into 3 ranges; mild, moderate and severe pain. During puncture the needle, the patients who received cold gel compression had decline of pain scores 57.8%, equal of pain scores 39.1% and increase of pain scores 3.1%. During steroid injection, the patients who received cold gel compression had decline of pain scores 82.8 %, equal of pain scores 14.1 % and increase of pain score 3.1%.

Conclusion: Cold gel compression before intralesional triamcinolone acetonide injection in keloid treatment was effective for pain relief during puncture the needle and injection of steroid with statistical and clinical significance. This method was also easy, safety, cheap and available in general practice.