title: Could 5-Fluorouracil or Triamcinolone Be an Effective Treatment Option for Keloid After Surgical Excision? A Meta-Analysis.
abstract: OBJECTIVE
  There is no universally accepted treatment regimen to decrease the recurrence rate of keloid formation after its removal, although many treatment options have been suggested. The purpose of this study was to investigate treatment options to prevent keloid recurrence after surgical excision.
  
  
  METHODS
  A systematic literature review and meta-analysis was performed using the Medline, Embase, and Cochrane databases. Predictor variables were 5-fluorouracil (5-FU) or triamcinolone adjuvant therapy, and the outcome variable was keloid recurrence rate. The Newcastle-Ottawa scale was used to assess the quality of the studies and the Cochrane risk-of-bias tool was used. Publication bias was evaluated using a funnel plot.
  
  
  RESULTS
  There were 1,224 publications identified; after screening, 5 were selected for review (1 retrospective cohort, 3 prospective cohorts, and 1 randomized controlled trial). The mean level of keloid recurrence was statistically lower in patients who received 5-FU compared with those who did not (control group; risk ratio, 0.18; 95% confidence interval [CI], 0.04 to 0.75). Triamcinolone was ineffective in lowering the keloid recurrence (risk difference, 0.06; 95% CI, -0.16 to 0.28).
  
  
  CONCLUSIONS
  5-FU can be considered an effective treatment to decrease keloid recurrence after surgical excision, although further research, including a randomized controlled trial, is required.
authors.affiliation: Professor, Department of Plastic and Reconstructive Surgery, College of Medicine, Chonbuk National University, Jeonju, Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Professor, Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju, Korea. Electronic address: kjsjdk@hanmail.net.
authors.forename: Jong Seung
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000963:Antimetabolites / Q000627:therapeutic use*; D005472:Fluorouracil / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007627:Keloid / Q000188:drug therapy*; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use*
chemical_list: D000963:Antimetabolites; D005938:Glucocorticoids; D014221:Triamcinolone; D005472:Fluorouracil