Objective To investigate the efficacy and safety of scar core excision combined with injection of botulinum toxin type A in the treatment of patients with keloids.
Methods A total of 186 patients with keloids in the Affiliated Hospital of Hebei University of Engineering from January 2021 to December 2023 were randomly divided into control group and study group, with 93 cases in each group. The control group was treated with scar core excision, while the study group was treated with scar core excision combined with injection of botulinum toxin type A. The Vancouver Scar Scale (VSS) score, the Visual Analogue Scale (VAS) score, scar area, scar thickness, laboratory indicators transforming growth factor-β1 (TGF-β1), basic fibroblast growth factor (bFGF), bone morphogenetic protein 7 (BMP-7), clinical efficacy, and adverse reactions were compared between the two groups. The patients were followed up for one year, and the recurrence rate of the two groups was compared.
Results At 3 and 12 months after treatment, the VSS score, the VAS score, scar area, and scar thickness in both groups decreased significantly, and those in the study group were significantly lower than those in the control group (P < 0.001). At 3 and 12 months after treatment, TGF-β1 decreased significantly, while bFGF and BMP-7 increased significantly in both groups, and TGF-β1 in the study group was significantly lower than that in the control group, while bFGF and BMP-7 were significantly higher than those in the control group (P < 0.001). The total effective rate in the study group was significantly higher than that in the control group (94.62% versus 76.34%, P < 0.001). The incidence of adverse reactions in the study group was significantly lower than that in the control group (2.15% versus 17.20%, P < 0.001). There was 1 case of recurrence in the study group, with a recurrence rate of 1.08%; 6 cases of recurrence in the control group, with a recurrence rate of 6.45%. The recurrence rate in the study group was lower than that in the control group (P>0.05).
Conclusion Scar core excision combined with injection of botulinum toxin type A has a good efficacy in the treatment of keloids, which can alleviate patients′ symptoms, shorten scar area and thickness, improve laboratory indicators, reduce the recurrence rate, and has few adverse reactions.
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