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CC BY 4.0 · Indian J Plast Surg 2025; 58(02): 105-109
DOI: 10.1055/s-0044-1801403
Original Article

Combination Therapy of 5-Fluorouracil and Triamcinolone Acetonide with Compression Therapy after Surgical Excision in the Management of Keloids in Ears

Authors

  • Randeep Singh Lamba 

    1   Department of Plastic and Reconstructive Surgery, Christian Medical College, Ludhiana, Punjab, India

  • Pinki Pargal 

    1   Department of Plastic and Reconstructive Surgery, Christian Medical College, Ludhiana, Punjab, India

  • Anurag Salwan

    1   Department of Plastic and Reconstructive Surgery, Christian Medical College, Ludhiana, Punjab, India

  • Junaise P.M

    1   Department of Plastic and Reconstructive Surgery, Christian Medical College, Ludhiana, Punjab, India

  • Pallavi Nigam

    1   Department of Plastic and Reconstructive Surgery, Christian Medical College, Ludhiana, Punjab, India

  • Noopur Bansal

    1   Department of Plastic and Reconstructive Surgery, Christian Medical College, Ludhiana, Punjab, India
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Abstract

Background Any deviation from the normal process of wound healing leads to excessive scar formation in the form of keloid or hypertrophic scar.

Materials and Methods The study included 120 candidates with keloids divided equally into two groups, A and B, of 60 patients each. After surgical excision, group A received combination therapy of intramarginal 5-fluorouracil (5-FU) and triamcinolone acetonide (TCA), while group B received only TCA, followed by compression therapy in both.

Results Eighty-seven patients had keloids on ear lobules, 25 (20.8%) on helix, and 8 (6.7%) over multiple locations on ear. Ninety-two (76.7%) had keloids over bilateral, 18 (15%) on left, and 10 (8.3%) on right ear. Sixty-three (52.5%) belonged to third, 65 (54.2%) to fourth, and 8 (6.7%) to fifth decade of life. Overall recurrence rate was 21.7 and 38.3% in group A and B, respectively. Recurrence was seen in 2 from group A (male:female 2:0) and 4 from group B (male:female 3:1) at 3 months, in 7 from group A (male:female 5:2) and 13 in group B (male:female 8:5) at 6 months, and in 4 from group A (male:female 3:1) and 6 from group B (male:female 5:1) at 1 year. Overall, pain was reported by 9 and 7 from group A and B, respectively, and burning sensation by 3 and 1 from group A and B, respectively. Ulceration was noted in 2, wound dehiscence in 1 and transient hyperpigmentation in 2 from group A. Based on the Vancouver Scar Scale, outcome on follow-up had an average of 3.5 at 3 months, 4.2 at 6 months, and 4.8 at 1 year in group A, and 3.8 at 3 months, 4.7 at 6 months, and 5.4 at 1 year in group B.

Conclusion Multimodal approach of combination therapy of intramarginal 5-FU and TCA with compression therapy after surgical excision of keloids in ears yields lower recurrence rate when compared with TCA alone. Chances of recurrence are more common in males than females. Though intramarginal 5-FU in combination with TCA has more localized side effects than TCA alone yet lower recurrence rate and better results in the long term can overcome the mild severity of these side effects.

Keywords

5-fluorouracil - compression therapy - keloid - triamcinolone acetonide


Publikationsverlauf

Artikel online veröffentlicht:
17. Januar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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