title: Comparison of single intra operative versus an intra operative and two post operative injections of the triamcinolone after wedge excision of keloids of helix.
abstract: OBJECTIVE
  To compare single intra-operative versus an intra-operative and two post-operative injections of triamcinolone after wedge excision of keloids of helix.
  
  
  METHODS
  The randomised controlled trial was conducted at the King Edward Medical University, Lahore, from January, 2011, to March, 2014, and comprised female patients over 14 years of age presenting with post-piercing keloids of helix not treated previously by any means and amenable to wedge excision. The subjects were divided into Group A who were given a single intra-operative injection of triamcinolone, and Group B who had an intra-operative and two post-operative injections of triamcinolone. Extra-lesional wedge excision of keloids was done, followed by infiltration of flaps and wound base with 0.5-1cc of triamcinolone 40mg/cc. Group B patients were given additional injections of triamcinolone at 1st and 2nd monthly visits. Both groups were observed for the evidence of hypertrophy or complications. Development of hypertrophy within one year of completion of treatment was considered recurrence.
  
  
  RESULTS
  The 70 patients in the study were divided into two equal groups of 35(50%) each. The mean age of Group A was 22.34±4.95 years and that of Group B was 22.88±4.22 years (p=0.624). The Mean size of the keloids was 2.54±0.516 cm(2) in Group A and 2.61±0.569 cm(2) in Group B (p=0.613). Recurrence rate in Group A was 3(8.5%) and 2(5.7%) in Group B (p= 0.64). The complication rate was 3(8.5%) in Group A and 8(22.8%) in Group B (p=0.10).
  
  
  CONCLUSIONS
  Single injection of triamcinolone was as effective as three in reducing recurrence with less complication rate.
authors.affiliation: Plastic Surgery Department, KEMU, Mayo Hospital, Lahore.
authors.forename: Muhammad Mustehsan
authors.initials: MM
authors.lastname: Bashir
authors.affiliation: Plastic Surgery Department, KEMU, Mayo Hospital, Lahore.
authors.forename: Hazqeel
authors.initials: H
authors.lastname: Ahmad
authors.affiliation: Plastic Surgery Department, KEMU, Mayo Hospital, Lahore.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Yousaf
authors.affiliation: Plastic Surgery Department, KEMU, Mayo Hospital, Lahore.
authors.forename: Farid Ahmad
authors.initials: FA
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D046288:Body Piercing / Q000009:adverse effects; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D054644:Ear Auricle / Q000601:surgery*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007627:Keloid / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*; D012008:Recurrence; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone
keywords: Keloid, Helix, Wedge excision, Ttriamcinolone.