A randomized clinical trial assessing the efficacy of single and multiple intralesional collagenase injections for treating contracted scars

Abstract

BackgroundScar contractions caused by trauma or burns can cause secondary physical dysfunction and disfigurement. Many minimally invasive methods for scar contraction have shown limited applicability and efficacy. This study investigated the feasibility and efficacy of intralesional collagenase injections for scar contraction treatment. MethodsPatients with contracted scars who had limited joint movement and physical disfiguration for >1 year were enrolled in this single-blind, randomized clinical trial from July 2017 to February 2018 ​at Shanghai Ninth People’s Hospital. Collagenase was injected into the firm-contracted scar (15 U/cm2) three times at 4-week intervals in the multiple treatment group and once in the single treatment group, and a placebo injection was performed in the control group. Scar length and skin texture were documented at the 4- and 12-week follow-ups. The safety of the collagenase treatment was also evaluated. ResultsThe contracted scar was significantly elongated after both single and multiple collagenase treatments. The results showed that, compared to a one-time treatment, repeated injections were more effective at 12 weeks, with an average improvement of 26.83 (15.79%). At 12 weeks, 78.9% of the patients in the multiple group and 52.9% in the single group achieved significant improvement at 12 weeks. No severe adverse events were observed. ConclusionIntralesional collagenase injection showed promising results in improving scar contraction and provides an alternative treatment for patients. Trial registrationChiCTR, ChiCTR-IIR-16009910. Registered November 18, 2016. Prospective registration, https://www.chictr.org.cn/showproj.html?proj=16853.