Date of Award

2017

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

Objective: The objective of the selective EBM review is to determine whether or not “Is the use of triamcinolone (TAC) in combination with 5-fluorouracil (5-FU) is more effective than TAC alone in the treatment of keloid scars?”

Study Design: Review of two (2) published, randomized control trials (RCT) and one (1) published, observational case control study (OCCS) in 2009 and 2014. All are in English.

Data Sources: The two (2) RCTs and the OCCS. Both were found using PubMed.

Outcomes Measured: Reduction in scar height and evolution of symptoms, specifically pain and pruritus. Other outcomes measured were erythema, length, width, height, and patient assessment.

Results: In the RCT by Khan at al., (2014) a larger reduction in scar height was found in the group that used the combination TAC + 5-FU, in comparison to TAC alone. In the OCCS by Darougheh et al. (2009) there was more significant improvement in height, width, length, and erythema in the group that used TAC in combination with 5-FU. Good results were concluded for self visual assessment showing greater satisfaction with the TAC + 5-FU group. In the RCT by Davison et al. (2009), the participants who had the greatest improvement in scar height of 92% underwent the treatment 5-FU with excision (group 1). The second group, which involved the use of 5-FU without excision, showed only 81% improvement. The third group, which involved TAC with excision, showed 73% improvement.

Conclusions: Both randomized control studies and clinical control study indicate that 5-FU + TAC is a more successful in regards to scar height and erythema in comparison to TAC alone.

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