Efficacy of triamcinolone acetonide combined with botulinum toxin A in the treatment of hypertrophic scars and keloids: A meta-analysis

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE Burns Pub Date : 2024-08-24 DOI:10.1016/j.burns.2024.08.016

Jianzhen Shi , Siqi Zhang , Ziyue Zhang , Jianru Xu , Yanmei Chen , Siyu Sun

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Abstract

Background

This meta-analysis aims to evaluate the efficacy and safety of triamcinolone acetonide (TCA) combined with botulinum toxin type A (BTA) for treating hypertrophic scars and keloids.

Methods

A comprehensive search of randomized controlled trials published before September 2023 was conducted across the Cochrane Library, Embase, PubMed, Web of Science, and CNKI databases. The analysis involved calculating pooled weighted mean difference (WMD), pooled risk ratios (RR), and 95 % confidence intervals (CI).

Results

Inclusive of 11 studies with a total of 561 patients, the meta-analysis revealed a statistically significant difference in the effective rate between the BTA+ TCA and control groups (RR = 1.28, 95 % CI = 1.14–1.44). Moreover, BTA+ TCA demonstrated a significant improvement in Visual Analog Scale scores (WMD = −1.69, 95 % CI = −2.72 – −0.66) and Vancouver Scar Scale scores (WMD = −1.46, 95 % CI = −1.90 – −1.02) compared to the control group. However, no statistically significant difference in scar thickness was observed between the BTA+ TCA and control groups (WMD = −0.11, 95 % CI = −0.30 - 0.09).

Conclusion

This meta-analysis showed that the combined use of BTA and TCA demonstrates high effectiveness in scar treatment, but its influence on scar thickness is limited. Future research should further explore the sources of heterogeneity and validate the long-term effects and safety of this therapy.

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曲安奈德联合 A 型肉毒毒素治疗增生性疤痕和瘢痕疙瘩的疗效：荟萃分析。

背景：本荟萃分析旨在评估曲安奈德（TCA）联合A型肉毒毒素（BTA）治疗增生性疤痕和瘢痕疙瘩的有效性和安全性：在 Cochrane Library、Embase、PubMed、Web of Science 和 CNKI 数据库中对 2023 年 9 月之前发表的随机对照试验进行了全面检索。分析包括计算汇总加权平均差 (WMD)、汇总风险比 (RR) 和 95 % 置信区间 (CI)：荟萃分析显示，BTA+ TCA 组和对照组的有效率差异有统计学意义（RR = 1.28，95 % CI = 1.14-1.44）。此外，与对照组相比，BTA+ TCA 显著改善了视觉模拟量表评分（WMD = -1.69, 95 % CI = -2.72 -0.66）和温哥华疤痕量表评分（WMD = -1.46, 95 % CI = -1.90 --1.02）。然而，BTA+ TCA 组和对照组之间的疤痕厚度差异无统计学意义（WMD = -0.11，95 % CI = -0.30 - 0.09）：这项荟萃分析表明，联合使用 BTA 和 TCA 对疤痕治疗有很高的疗效，但对疤痕厚度的影响有限。未来的研究应进一步探索异质性的来源，并验证这种疗法的长期效果和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.