title: Intralesional cryosurgery combined with topical silicone gel sheeting for the treatment of refractory keloids.
abstract: BACKGROUND
  A variety of therapeutic procedures for treating keloids have been previously reported, with varying success and recurrence rates. As a monotherapy, intralesional cryosurgery has yielded convincing clinical results.
  
  
  OBJECTIVE
  We combined intralesional cryosurgery with the application of topical silicone gel sheeting.
  
  
  METHODS
  In this retrospective study, which was conducted between 2008 and 2012, 21 patients with 32 keloids were enrolled. Twenty-five lesions were treated with intralesional cryotherapy combined with postoperative silicone gel sheeting (the cryotherapy + silicone group), and 7 keloids were treated with intralesional cryotherapy alone (the cryotherapy group). The scar volume reduction was assessed, and the patients' subjective and objective parameters were evaluated. Additionally, patient satisfaction was estimated using a modified Gorney Gram scale (0-3).
  
  
  RESULTS
  In all cases (n = 32 for both groups), a significant keloid volume reduction was observed. The patients' subjective complaints were significantly improved, whereas the combined therapy showed slightly better results in hardness (p < .0012), pain (p < .0233), and discomfort (p < .0029), whereas monotherapy achieved higher satisfaction scores in redness (p < .0220) and pruritus (p < .0206), although these differences were not significant between the treatment modalities.
  
  
  CONCLUSIONS
  The results of this study support the use of combined intralesional cryosurgery followed by the application of silicone gel sheeting to treat refractory keloids.
authors: *Department of Plastic Surgery, Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany; †The Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.
authors: Jan-Philipp
authors: JP
authors: Stromps
authors: Sebastian
authors: S
authors: Dunda
authors: Ron-Julius
authors: RJ
authors: Eppstein
authors: Denis
authors: D
authors: Babic
authors: Yaron
authors: Y
authors: Har-Shai
authors: Norbert
authors: N
authors: Pallua
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D003131:Combined Modality Therapy / Q000009:adverse effects; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D004890:Erythema / Q000209:etiology; D005260:Female; D006801:Humans; D007627:Keloid / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011537:Pruritus / Q000209:etiology; D012189:Retrospective Studies; D020034:Silicone Gels / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D020034:Silicone Gels