Injection complications and change in keloid height following intralesional injection of lesions: a novel injection system compared with the traditional method

Abstract

Injection complications can compromise the accuracy of the dosage of a medication, which is critical to keloid treatment success. This study aims to compare the incidence of injection complications of a metal dental syringe injection system with that of the traditional plastic hypodermic syringe, and the change in keloid height associated with their use in intralesional keloid injection of triamcinolone. Complications of the injection systems such as inability to inject due to toughness of the tissue, spillage of the drug following separation of a friction-gripped needle from the syringe, backflow of the drug through the space between the plunger and barrel, bending of the plunger and outright breakage of the injected skin were documented. A visual analogue scale (VAS) was administered to measure pain experienced by patients. Change in height of lesions was documented. Eighty-eight lesions were injected: 44 were injected using the metal dental syringe system while another 44 were injected using a plastic hypodermic syringe. The metal dental syringe system was involved in fewer incidents of skin breakage and backflow of liquid medication than the traditional. The traditional system was involved in three other complications. The mean (VAS) pain score of 78 mm was derived for patients injected using the metal dental syringe system, while 71 mm was the corresponding value for the traditional. The keloid flattening rate was greater in the group injected using the metal dental syringe system. The metal dental syringe delivery system recorded fewer complications during intralesional injection of triamcinolone than the traditional plastic syringe system. Level of Evidence: Level III, risk/prognostic study.