Comparing the Efficacy of Triamcinolone Acetonide Versus Bleomycin in Hypertrophic Scars in Burn Patients: A Clinical Trial.

Background: Treatment of hypertrophic burn scars is challenging. Intralesional injection of corticosteroids has been the first line of treatment. Triamcinolone Acetonide (TA) and Bleomycin (BLE) are standard therapeutic options. We conducted a comparative study to measure the effects of BLE and TA on hypertrophic burn scars.

Methods: In this clinical trial, we enrolled 25 patients with hypertrophic burn scars in this study. In each patient, two adjacent affected areas on the body were randomly selected for intralesional injection of TA and BLE. The size of the burn scars was between 10 and 40 cm2 (square centimeter). The injections were repeated at intervals of four weeks for three periods. Follow-up of patients continued until the end of the fourth month of treatment. We used the Vancouver Scar Scale and Patient and Observer Scar Assessment Scale system to compare the recovery of each lesion. Means, standard deviation, and p-values comparing the treatment of lesions with BLE and TA using two different scales were reported. Independent samples t-test and paired sample t-test were used to find out a statistically significant difference between BLE and TA treated lesions.

Results: The results showed that the hypertrophic scar scores in BLE and TA lesions were statistically significant from the perspective of patients and physicians (P = 0.035). The mean score of hypertrophic scars in the BLE and TA groups was also statistically significant (P = 0.023). The proportion of individuals who had no side effects after taking BLE and TA was much higher than those who experienced skin pain or hypopigmentation.

Conclusion: Intralesional BLE injection is more effective than TA in treating hypertrophic scars. Further studies with larger sample sizes are needed to approve these results.