title: Topical mitomycin C in the prevention of keloid scar recurrence.
abstract: OBJECTIVE
  To assess the ability of mitomycin C to prevent the recurrence of surgically excised keloid scars. Mitomycin C has been successfully used to prevent scar tissue formation at the site of subglottic stenosis in the field of pediatric otolaryngology. It appears that mitomycin C interferes with the ability of fibroblasts to produce a scar without causing changes in epithelialization.
  
  
  METHODS
  We excised keloid scars from various sites in the head and neck and then applied mitomycin C to the resected bed prior to closure of the wound at a concentration of 0.4 mg/mL for 5 minutes. All patients had multiple keloids and acted as their own control. At 1 month after the procedure both wounds were started on a regimen of triamcinolone acetonide, 40 mg/mL injections, repeated every month for 6 months. At the end of the study, photos and measurements were again taken.
  
  
  RESULTS
  Fifteen patients (13 female and 2 male) ranging in age from 10 to 55 years enrolled in the study. No infections or nonhealing wounds were seen. There was no difference in postoperative pain. Eight patients completed the triamcinolone injections, 5 had fewer than 6 injections, and 2 patients had no steroid injections. Twelve patients completed follow-up and were evaluated for surgical complications and recurrence of the keloids at either site. Two patients had partial postoperative follow-up in person and then completed follow-up via telephone. One patient could not be found for follow-up. Four patients had recurrence of both excised lesions. Ten patients had no recurrence of their keloids at either site.
  
  
  CONCLUSIONS
  Mitomycin C made no difference in the prevention of keloid recurrence after excision when topically applied.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, USA.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Sanders
authors.forename: Linda
authors.initials: L
authors.lastname: Gage-White
authors.forename: Fred J
authors.initials: FJ
authors.lastname: Stucker
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D017439:Cicatrix, Hypertrophic / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004431:Ear, External; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007627:Keloid / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009333:Neck; D012189:Retrospective Studies; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D016685:Mitomycin