Topical silicone gel sheet versus intralesional injections of triamcinolone acetonide in the treatment of keloids — a patient-controlled comparative clinical trial

Abstract

Objective: This prospective, patient-controlled study aimed to assess the effectiveness of topical silicone gel sheet and intralesional injections of triamcinolone acetonide (40 mg/ml) in the treatment of keloids.Methods: Twenty patients with multiple keloids were recruited for this study which lasted 12 weeks. In each patient, three keloids of similar size were selected. One was assigned to no' treatment (control) and one to each active treatment. For treatment, patients were instructed to place the sheet over the assigned keloid for 12 h daily for 12 weeks, while intralesional injections of triamcinolone acetonide (40 mg/ml) were administered to the other assigned keloid.Results: None of the untreated control lesions showed any spontaneous reduction in size. Of the lesions treated with silicone gel sheet dressing, only 2 of 17 (12%) showed a significant reduction in size (i.e. at least 50% reduction in size) at week 12. This was not statistically significant when compared with the untreated control lesions (P> 0.05, Fisher's exact test). Of the lesions treated with intralesional injections of triamcinolone acetonide (40 mg/ml), 16 of 17 (94%) showed a significant reduction in size at week 12. This was statistically significant when compared with the untreated control lesions (P<0.05). Of the two modalities of treatment, intralesional injections of triamcinolone acetonide (40 mg/ml) were therefore found to be significantly more effective than silicone gel sheet dressing.Conclusion: Our results do not support the use of occlusive silicone gel sheet as an effective treatment of chronic keloid scars. The effectiveness of intralesional injections of triamcinolone acetonide (40 mg/ml) was well demonstrated by this study and should remain one of the primary methods for the treatment of keloids.