Objective  To investigate the clinical efficacy of triamcinolone acetonide combined with punch excision in the treatment of keloids.

Methods  Patients with keloids diagnosed and treated in The First Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to January 2022 were retrospectively collected. Patients with keloids were divided into conservative (triamcinolone acetonide and fluorouracil) and non-conservative (punch excision combined with treamcinolone acetonide and fluorouracil) according to their treatment regimens. The scores of the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS) and the Visual Analogue Rating Scale (VAS) were compared before and after treatment, the total effective rate was calculated to evaluate, the clinical efficacy, and the occurrence of adverse events was observed to evaluate the safety.

Results  A total of 99 patients with keloids were included in the study, including 53 in the conservative treatment group and 46 in the non-conservative treatment group. Before treatment, there was no significant difference in POSAS score, VSS score and VAS score between the two groups (P>0.05). Compared with the conservative treatment group, the POSAS score, VSS score and VAS score of the non-conservative treatment group decreased significantly after treatment (P<0.05). The total effective rate of treatment in the non-conservative treatment group was significantly higher than that in the conservative treatment group (P<0.05). In terms of adverse reactions, the risk of bleeding increased, the incidence of skin pigmentation decreased, and the telangiecasia and skin atrophy didn't occur in the non-conservative treatment group.

Conclusion  Triamcinolone acetonide combined with punch excision has a significant effect on keloids, which can reduce the incidence of skin atrophy but increase the risk of bleeding.

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