The Efficacy of Local Application of Mitomycin C in Reducing Recurrence Rate of Keloid after Surgery
Article Sidebar
Main Article Content
Abstract
Introduction
Keloid is a hyperproliferative response of the fibroelastic connective tissue to dermal trauma, appearing predominantly in areas of high skin tension. Surgical excision produces immediate cosmetic correction, but recurrence rates after surgical treatment alone are high and post excision adjunct therapies should be considered. Topical application of Mitomycin C has shown to suppress cell division, fibroblast proliferation, protein and collagen synthesis and angiogenesis. In our study we applied it locally after surgical excision of keloid of auricle and compared the outcome with post-surgical perilesional Triamcinolone acetonide injection to reduce recurrence.
Materials and Method
Fifty cases with primary or recurrent keloid over auricle were studied from February 2015 to January 2016. They are divided into two groups; Group 1 received local Mitomycin C application after keloid excision while Group 2 had perilesional injection of Triamcinolone acetonide after surgical excision of keloid. The results were compared 6 months after the initial treatment.
Result
There was no statistical difference in the baseline characteristics like age, sex, type of symptoms and previous history of recurrence between the two groups. Most of the patients in both the groups were aged between 14 and 30 years. The study population constituted predominantly of females. At the end of 6 months follow up, the recurrences noted were 5 and 6 respectively in Group 1 and 2 out of 25 patients in each group.
Conclusion
After surgical excision of keloid, topical application of Mitomycin C is as effective as intralesional Triamcinolone acetonide injection in terms of recurrence of the keloids affecting the auricle.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Sanders KW, Gage-White L, Stucker FJ. Topical Mitomycin C in the prevention of keloid scar recurrence. Arch Facial Plast Surg. 2005; 7(3):172-5
Prakash NS, Mallikarjunappa AM, Agarwal P. Effect of Mitomycin C application on head and neck keloids. Journal of Evolution of Dental and Medical Sciences 2013; 2(33):6350-55
Annino DJ Jr, Goguen LA. Mitomycin C for the treatment of pharygoesophageal stricture after total laryngopharyngectomy and microvascular free tissue reconstruction. Laryngoscope 2003; 113(9):1499-502
Rahbar R, Jones DT, Nuss RC, McLeod IK, Brooks DB, Mair EA et al. Revision choanal atresia repair. Int J Pediatr Otorhinolaryngol. 2003; 67(5):517-24
Rahbar R, Jones DT, Nuss RC, Roberson DW, Kenna MA, McGill TJ, Healy GB. The role of mitomycin in the prevention and treatment of scar formation in the pediatric aerodigestive tract: friend or foe? Arch Otolaryngol Head Neck Surg. 2002; 128(4):401-6
Gupta M, Narang TJ. Role of Mitomycin C in reducing keloid recurrence: patient series and literature review. J Laryngol Otol. 2011; 125(3):297-300. doi: 10.1017/S0022215110002045
Stucker FJ, Ed Hoasjoe, DK Ed Aarstad, R Fed. Current Therapy In Otolaryngology–Head and Neck Surgery. 5th Ed. St Louis, Mo Mosby-Yearbook Inc.1994;113-8
Stucker FJ, Goco PE. The treatment of hypertrophic scars and keloids. Facial Plast Surg Clin North Am. 1998; 6191-4
Chi SG, Kim JY, Lee WJ, Lee SJ, Kim do W, Son MY, Kim GW, Kim MB, Kim BS. Ear keloids as a primary candidate for the application of mitomycin C after shave excision: in vivo and in vitro study. Dermatol Surg. 2011; 37(2):168-75
Shridharani SM, Magarakis M, Manson PN, Singh NK, Basdag B, Rosson GD. The emerging role of antineoplastic agents in the treatment of keloids and hypertrophic scars: a review. Ann Plast Surg. 2010; 64(3):355-61
Wang XQ, Liu YK, Qing C, Lu SL. A review of the effectiveness of antimitotic drug injections for hypertrophic scars and keloids. Ann Plast Surg. 2009; 63(6):688-92
Froelich K, Staudenmaier R, Kleinsasser N, HagenR.Eur Arch. Therapy of auricular keloids: review of different treatment modalities and proposal for a therapeutic algorithm. Otorhinolaryngol. 2007; 264(12):1497-508
Bailey JN, Waite AE, Clayton WJ, Rustin MH. Application of topical mitomycin C to the base of shave-removed keloid scars to prevent their recurrence. Br J Dermatol. 2007; 156(4):682-6
Ramakrishnan KM, Thomas KP, Sundararajan CR. Study of 1000 patients with keloid in south India. PlastReconstr Surg. 1974;53:276-80
Fruth K, Gouveris H, Kuelkens C, Mann WJ. Radiofrequency tissue volume reduction for treatment of auricle keloids; laryngoscope 2011;121:1233-6
Stewart CE, Kim JK. Application of Mitomycin C for head and neck keloids. Otolaryngology and Head Neck Surgery 2006; 135: 946-950.