title: Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes.
abstract: BACKGROUND
  The aim of this review was to explore the existing body of literature focusing on the intralesional treatments of keloids and hypertrophic scars.
  
  
  METHODS
  A comprehensive systematic review of related articles was conducted across multiple databases. Article selection was limited to those published in the English language between 1950 and 2014. Search terms for the on-line research were "scar(s)," "keloid(s)," "hypertrophic," "injection," "intralesional," and "treatment".
  
  
  RESULTS
  The initial search returned 2548 published articles. After full text review, the final search yielded 11 articles that met inclusion criteria. A total of 14 patient samples in 11 articles were collected. The most frequent intralesional injection treatment studied was triamcinolone (n = 5), followed by bleomycin (n = 3), 5-fluorouracil (n = 2), verapamil (n = 2), cryosurgery, and collagenase. The scar height reduction for all but one study was demonstrated, with acceptable complication and recurrence rate. Only three articles reported a follow-up period longer than 18 months, and only two studies used standardized outcome criteria with a quantitative scale.
  
  
  CONCLUSIONS
  Although many treatment options have already been described in the literature, there is no universally accepted treatment resulting in permanent hypertrophic or keloid scar ablation. The lack of adequately long-term powered randomized controlled trials does not permit to establish definitive conclusions with implications for routine clinical practice.
  
  
  METHODS
  III/Therapeutic.
authors: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, 639 Zhi Zao Ju Road, 200011 Shanghai, P.R. China.
authors: Aurelia
authors: A
authors: Trisliana Perdanasari
authors: Department of Plastic and Reconstructive Surgery, Marche Polytechnic University Medical School, University Hospital of Ancona, Ancona, Italy.
authors: Matteo
authors: M
authors: Torresetti
authors: Department of Plastic and Reconstructive Surgery, Marche Polytechnic University Medical School, University Hospital of Ancona, Ancona, Italy.
authors: Luca
authors: L
authors: Grassetti
authors: Department of Plastic Reconstructive and Aesthetic Surgery, University of Rome, Rome, Italy.
authors: Fabio
authors: F
authors: Nicoli
authors: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, 639 Zhi Zao Ju Road, 200011 Shanghai, P.R. China.
authors: Yi Xin
authors: YX
authors: Zhang
authors: Plastic Reconstructive and Aesthetic Surgery Unit, Villa Salaria Clinic, Rome, Italy.
authors: Talal
authors: T
authors: Dashti
authors: Department of Plastic and Reconstructive Surgery, Marche Polytechnic University Medical School, University Hospital of Ancona, Ancona, Italy.
authors: Giovanni
authors: G
authors: Di Benedetto
authors: Plastic Reconstructive and Aesthetic Surgery Unit, Villa Salaria Clinic, Rome, Italy.
authors: Davide
authors: D
authors: Lazzeri
keywords: Hypertrophic scar; Intralesional injections; Keloid; Outcomes; Systematic review