Keloids Clinical Studies Of Combination Therapy

Objective:To explore an effective and safe therapeutic strategy in the management of keloid by comparing the curative effects of three different methods(operation+inject diprospan during surgery+radiotherapy after surgery,operation+radiotherapy after surgery, only diprospan by local injection)Methods:This study is a randomized,parallel-controlled trial.81 cases of patients with keloid collected in our hospital from September 2007 to Merch 2009 were randomly divided into three groups:Group A(n=27),keloids were removed by operation with diprospan injected in local area,⁹⁰Sr-⁹⁰Y contact therapy was given to each cases after surgery.Esposure dose every time is 600～800cGy,depending on the thickness of the scar,every other day,10 times a course of treatment;Group B(n=27),keloids were removed by operation without local use of diprospan,⁹⁰Sr-⁹⁰Y was given to each cases after surgery.The number and doses of radiotherapy are the same with the A group; Group C(n=27),keloids were treated with only diprospan by local injection once a month,3 to 6 times in all.Observe the signs and symptoms of patients after treatment.All patients were followed up for 12 months at least.Healing rates,effective rates,and side effects of the three groups were recorded,and compared using X² testing with software SPSS 11.5.Results:By the end of the follow-up visit of the clinical trial observation one year later,it indicated that a group of 23 completed the revisit,the healing rate reached 86.96%, effectiveness reached 95.65%;B group of 24 completed the revisit,the healing rate reached 75.00%,the effective rate reached 87.50%;C group of 26 completed the revisit, the healing rate reached 30.77%,the effective rate reached 57.69%.The healing rate,the effective rate of A & B group surpassed C group obviously,the difference had statistics significance.The healing rate,the effective rate of A group surpassed B group,but it had not difference in statistics.In this research,two cases of A group and one case of B group appear the phenomenon of partial rupture in the operation area,it did not affect the treatment effect,the not healing of the incision margin did not appeared in A,B group.Conclusion:It is revealed that surgery in combination with postoperative ⁹⁰Sr-⁹⁰Y contact therapy is safe and effective for patients with keloid.The healing rate and the effective rate is slightly higher than the former after injecting diprospan during surgery, but not statistically significant,which imply that diprospan does not affect wound healing.