PMID- 37967571
OWN - NLM
STAT- Publisher
LR  - 20240228
IS  - 1742-481X (Electronic)
IS  - 1742-4801 (Print)
IS  - 1742-4801 (Linking)
VI  - 21
IP  - 3
DP  - 2023 Nov 15
TI  - Comparison of surgical excision followed by adjuvant radiotherapy and laser 
      combined with steroids for the treatment of keloids: A systematic review and 
      meta-analysis.
PG  - e14449
LID - 10.1111/iwj.14449 [doi]
LID - e14449
AB  - This meta-analysis aims to evaluate and compare the effect of surgical excision 
      followed by adjuvant radiotherapy and laser combined with steroids on keloids. 
      Relevant studies reporting the recurrence rate or incidence of adverse events 
      (AEs) were retrieved from the PubMed, Web of Science, Embase and Cochrane Library 
      databases through August 2023. The quality of noncomparative single-arm clinical 
      trials was evaluated using the methodological index for nonrandomised studies 
      (MINORS) Methodological items. This meta-analysis was conducted utilizing Stata 
      12.0 statistical software. 26 studies involving 989 patients were included in the 
      analysis. The recurrence rate in the laser combined with steroids therapy group 
      (12.2%, 95% confidence interval [CI]: 5.9%-18.5%) was lower than that of the 
      surgical excision combined with radiotherapy group (13.5%, 95% CI: 6.6%-22.2%). 
      For the incidence of AEs, relatively low incidence of atrophy (0.0%, 95% CI: 
      0.0%-1.2%), telangiectasia (3.2%, 95% CI: 0.4%-7.6%), erythema (2.3%, 95% CI: 
      0.0%-10.6%), infection (0.2%, 95% CI: 0.0%-1.6%) and high hyperpigmentation rate 
      (8.3%, 95% CI: 4.2%-13.4%) were obtained in the surgical excision combined with 
      radiotherapy group. Compared with surgical resection followed by radiotherapy, 
      the combination of laser and steroids for keloids showed a lower 
      hyperpigmentation rate (6.5%), as well as a higher incidence of atrophy (22.7%), 
      telangiectasia (6.4%), erythema (3.3%) and infection (3.3%). Only a 
      hypopigmentation rate of 2.9% was obtained in patients treated with surgical 
      excision plus radiotherapy. Current evidence revealed that surgical excision 
      followed by adjuvant radiotherapy and laser combined with steroids therapy were 
      effective and safe treatments for keloids, with relatively low recurrence rate 
      and complication rate. Comparative studies are needed to further compare the 
      effects of these two combination therapies on keloids.
CI  - (c) 2023 The Authors. International Wound Journal published by Medicalhelplines.com 
      Inc and John Wiley & Sons Ltd.
FAU - Fu, Siqi
AU  - Fu S
AD  - Department of Dermatology, Second Xiangya Hospital, Central South University, 
      Changsha, China.
FAU - Duan, Liu
AU  - Duan L
AD  - Department of Dermatology, The Third Hospital of Changsha, Changsha, China.
FAU - Zhong, Yan
AU  - Zhong Y
AD  - Department of Preventive Medicine, School of Medicine, Hunan Normal University, 
      Changsha, China.
FAU - Zeng, Yu
AU  - Zeng Y
AD  - Hunan Provincial University Key Laboratory of the Fundamental and Clinical 
      Research on Neurodegenerative Diseases, Changsha Medical University, Changsha, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20231115
PL  - England
TA  - Int Wound J
JT  - International wound journal
JID - 101230907
SB  - IM
PMC - PMC10895202
OTO - NOTNLM
OT  - keloid
OT  - laser
OT  - radiotherapy
OT  - steroid
OT  - surgical excision
COIS- The authors declare that there is no conflict of interest.
EDAT- 2023/11/16 00:42
MHDA- 2023/11/16 00:42
PMCR- 2023/11/15
CRDT- 2023/11/15 19:02
PHST- 2023/09/04 00:00 [received]
PHST- 2023/10/10 00:00 [accepted]
PHST- 2023/11/16 00:42 [pubmed]
PHST- 2023/11/16 00:42 [medline]
PHST- 2023/11/15 19:02 [entrez]
PHST- 2023/11/15 00:00 [pmc-release]
AID - IWJ14449 [pii]
AID - 10.1111/iwj.14449 [doi]
PST - aheadofprint
SO  - Int Wound J. 2023 Nov 15;21(3):e14449. doi: 10.1111/iwj.14449.