Needle-Free Jet Injector-Assisted Triamcinolone Treatment of Keloids and Hypertrophic Scars is Effective and Well Tolerated in Children

IF 2.9 3区医学 Q2 PHARMACOLOGY & PHARMACY Clinical Drug Investigation Pub Date : 2023-12-13 DOI:10.1007/s40261-023-01332-0

Vazula Zulfra Bekkers, Claire Van Eijsden, Qi Yin, Albert Wolkerstorfer, Errol Prospero Prens, Martijn Bastiaan Adriaan van Doorn

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Abstract

Background

Keloids and hypertrophic scars can cause severe pain, pruritus, and psychological distress. Conventional intralesional corticosteroid treatment with needle injections remains challenging, especially in children with needle phobia.

Objective

We aimed to evaluate the effectiveness, tolerability, and patient satisfaction of intralesional treatment with triamcinolone acetonide using a needle-free electronic pneumatic jet injector in children with keloids and hypertrophic scars.

Methods

A retrospective study was performed in children with keloids and hypertrophic scars who received intralesional triamcinolone acetonide treatments using an electronic pneumatic jet injector. Effectiveness was evaluated using the Patient and Observer Scar Assessment Scale and Global Aesthetic Improvement Score at follow-up versus baseline. Tolerability was assessed with reported adverse effects and injection-related pain using a visual analog scale. Satisfaction questionnaires were used to evaluate treatment-related patient satisfaction.

Results

Six female patients and five male patients aged 5–17 years, with a total of >118 keloids or hypertrophic scars were included. Electronic pneumatic jet injector treatment led to a significant reduction in the total Patient and Observer Scar Assessment Scale observer and patient scores compared with baseline, with a median reduction of 28.9% and 23.8%, respectively (p = 0.005; p = 0.009). Median visual analog scale pain scores for electronic pneumatic jet injector treatment were significantly lower compared with needle injections, 3.0 versus 7.0, respectively (p = 0.027). No severe adverse effects were reported. Overall, 6 patients were ‘satisfied’ and five patients were ‘very satisfied’ with the treatment.

Conclusions

Electronic pneumatic jet injector-assisted intralesional triamcinolone acetonide is an effective and well-tolerated treatment for keloids and hypertrophic scars in children. It should be considered as an alternative non-traumatic delivery method, especially in children with needle phobia or severe pain during previous needle injections.

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无针喷射器辅助曲安奈德治疗儿童瘢痕疙瘩和肥厚性疤痕有效且耐受性良好

背景:瘢痕疙瘩和增生性疤痕可引起剧烈疼痛、瘙痒和心理困扰。传统的局部注射皮质类固醇治疗仍然具有挑战性，特别是对有针恐惧症的儿童。目的评价无针电子气动喷雾器在瘢痕疙瘩和增生性瘢痕患儿局部注射曲安奈德的疗效、耐受性和患者满意度。方法对瘢痕疙瘩和增生性瘢痕患儿应用电子气动喷雾器局部注射曲安奈德治疗的回顾性研究。使用患者和观察者疤痕评估量表和总体美学改善评分对随访和基线进行有效性评估。使用视觉模拟量表评估耐受性，报告不良反应和注射相关疼痛。采用满意度问卷评估与治疗相关的患者满意度。结果女性6例，男性5例，年龄5 ~ 17岁，共118例瘢痕疙瘩或增生性瘢痕。与基线相比，电子气动喷射器治疗导致患者和观察者疤痕评估量表的观察者和患者总得分显著降低，中位数分别降低28.9%和23.8% (p = 0.005;P = 0.009)。电子气动喷射器治疗的视觉模拟疼痛评分中位数明显低于针注射，分别为3.0分和7.0分(p = 0.027)。没有严重的不良反应报告。总体而言，6名患者对治疗“满意”，5名患者对治疗“非常满意”。结论电子气动喷雾器辅助局部注射曲安奈德是治疗儿童瘢痕肿和增生性瘢痕的有效方法。应考虑将其作为一种非创伤性分娩方法，特别是在以前针头注射时有针头恐惧症或剧烈疼痛的儿童中。

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来源期刊

Clinical Drug Investigation 医学-药学

CiteScore

5.90

自引率

3.10%

发文量

108

审稿时长

6-12 weeks

期刊介绍： Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.