Limits...
Intralesional Cryotherapy for the Treatment of Keloid Scars: Evaluating Effectiveness.

van Leeuwen MC, Bulstra AE, Ket JC, Ritt MJ, van Leeuwen PA, Niessen FB - Plast Reconstr Surg Glob Open (2015)

Bottom Line: The average scar volume decrease ranged from 51% to 63%, but no complete scar eradication was achieved on average.Finally, complaints of pain and pruritus decreased significantly in most studies.Also, persistent hypopigmentation proved a problem in Fitzpatrick 4-6 skin type patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands; Medical Library, VU University, Amsterdam, The Netherlands; and Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT

Background: Intralesional (IL) cryotherapy is a novel treatment technique for keloid scars, in which the scar is frozen from inside. Over the past decade, several studies have been published with varying outcomes. A critical analysis of the current literature is, therefore, warranted to determine whether IL cryotherapy is an alternative to established keloid scar treatments.

Methods: A comprehensive review was performed, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed and EMBASE were searched from inception. Studies and level of recommendation were graded according to the American Society of Plastic Surgeons criteria.

Results: Eight studies meeting the inclusion criteria were selected. The average scar volume decrease ranged from 51% to 63%, but no complete scar eradication was achieved on average. Scar recurrence ranged from 0% to 24%. Hypopigmentation posttreatment was seen mostly in Fitzpatrick 4-6 skin type patients. Finally, complaints of pain and pruritus decreased significantly in most studies.

Conclusions: IL cryotherapy for the treatment of keloid scars shows favorable results in terms of volume reduction and alleviated complaints of pain and pruritus. However, no complete scar eradication is established, and recurrences are seen. Also, persistent hypopigmentation proved a problem in Fitzpatrick 4-6 skin type patients. Summarized, the evidence proved limited and inconsistent resulting in an American Society of Plastic Surgeons grade C recommendation for this type of treatment of keloid scars.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of the search and selection process according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis. *2 accepted records, included from the VU Medical Center Research database.25,26
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4494507&req=5

Figure 1: Flow diagram of the search and selection process according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis. *2 accepted records, included from the VU Medical Center Research database.25,26

Mentions: The article screening process was performed as follows: 3 investigators (M.C.E.v.L., A.E.J.B., and J.C.F.K.) carried out the initial searches and 2 investigators (M.C.E.v.L. and A.E.J.B.) independently reviewed the studies for eligibility. Investigators were blinded to each other, meeting only to compare findings after completing the extraction process. Decisions about eligibility were resolved by discussion. Seventy-six potentially relevant studies were identified from the initial searches. Subsequently, 2 authors (M.C.E.v.L. and A.E.J.B.) independently screened the full-text articles for eligibility using a standardized data extraction form with inclusion and exclusion criteria. Disagreement was resolved through discussion. This resulted in the inclusion of 8 articles (Fig. 1).


Intralesional Cryotherapy for the Treatment of Keloid Scars: Evaluating Effectiveness.

van Leeuwen MC, Bulstra AE, Ket JC, Ritt MJ, van Leeuwen PA, Niessen FB - Plast Reconstr Surg Glob Open (2015)

Flow diagram of the search and selection process according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis. *2 accepted records, included from the VU Medical Center Research database.25,26
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494507&req=5

Figure 1: Flow diagram of the search and selection process according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis. *2 accepted records, included from the VU Medical Center Research database.25,26
Mentions: The article screening process was performed as follows: 3 investigators (M.C.E.v.L., A.E.J.B., and J.C.F.K.) carried out the initial searches and 2 investigators (M.C.E.v.L. and A.E.J.B.) independently reviewed the studies for eligibility. Investigators were blinded to each other, meeting only to compare findings after completing the extraction process. Decisions about eligibility were resolved by discussion. Seventy-six potentially relevant studies were identified from the initial searches. Subsequently, 2 authors (M.C.E.v.L. and A.E.J.B.) independently screened the full-text articles for eligibility using a standardized data extraction form with inclusion and exclusion criteria. Disagreement was resolved through discussion. This resulted in the inclusion of 8 articles (Fig. 1).

Bottom Line: The average scar volume decrease ranged from 51% to 63%, but no complete scar eradication was achieved on average.Finally, complaints of pain and pruritus decreased significantly in most studies.Also, persistent hypopigmentation proved a problem in Fitzpatrick 4-6 skin type patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands; Medical Library, VU University, Amsterdam, The Netherlands; and Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT

Background: Intralesional (IL) cryotherapy is a novel treatment technique for keloid scars, in which the scar is frozen from inside. Over the past decade, several studies have been published with varying outcomes. A critical analysis of the current literature is, therefore, warranted to determine whether IL cryotherapy is an alternative to established keloid scar treatments.

Methods: A comprehensive review was performed, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed and EMBASE were searched from inception. Studies and level of recommendation were graded according to the American Society of Plastic Surgeons criteria.

Results: Eight studies meeting the inclusion criteria were selected. The average scar volume decrease ranged from 51% to 63%, but no complete scar eradication was achieved on average. Scar recurrence ranged from 0% to 24%. Hypopigmentation posttreatment was seen mostly in Fitzpatrick 4-6 skin type patients. Finally, complaints of pain and pruritus decreased significantly in most studies.

Conclusions: IL cryotherapy for the treatment of keloid scars shows favorable results in terms of volume reduction and alleviated complaints of pain and pruritus. However, no complete scar eradication is established, and recurrences are seen. Also, persistent hypopigmentation proved a problem in Fitzpatrick 4-6 skin type patients. Summarized, the evidence proved limited and inconsistent resulting in an American Society of Plastic Surgeons grade C recommendation for this type of treatment of keloid scars.

No MeSH data available.


Related in: MedlinePlus