The 1470 nm diode laser with an intralesional fiber device:a proposed solution for the treatment of inflamed and infected keloids

Background:Keloids are the result of abnormal wound healing and often are subject to infections and recurrent inflammation.We present a study conducted with a 1470 nm diode laser using an intralesional optical fiber device for the treatment of inflamed keloid scars.We evaluate its efficacy as a novel alternative method to decrease keloid infection and inflammation.Methods:The patients who underwent 1470 nm laser treatment from February 2016 to February 2018 at the plastic and reconstructive surgery department of the Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University with keloid accompanying serious local infection and fester were included.Patients took curative effect evaluation before and 1 year after the treatment.The test items included infection frequency in each year;pain,by visual analogue scale(VAS);itch,using VAS;quality of life(QOL),using QOL scale;and blood supply,using PeriCam PSI.Results:A total of 19 patients(mean age 35.21 years,range 11–66)with history of inflamed keloids with episodes of infection or abscess were enrolled.Patients underwent to a 1470 nm laser therapy for average of 1.16 times.After treatment,infection frequency and blood supply in keloids were reduced(p<0.001).Pain,itching,and QOL were improved(p<0.001).Conclusion:The present study shows that 1470 nm fiber laser treatment could improve inflamed keloids fairly well by decreasing inflammation,and a relative stabilization of collagen composition.Therefore,it is an effective minimally invasive scar therapy,but further studies are essential to confirm the present results.

Intralesional injection treatment of hypertrophic scars and keloids:a systematic review regarding outcomes

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),fol owed 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 universal y accepted treatment resulting in permanent hypertrophic or keloid scar ablation.The lack of adequately long-term powered randomized control ed trials does not permit to establish definitive conclusions with implications for routine clinical practice.Level of