Problems of Radiation Medicine and Radiobiology

V. Teplyi, K. Grebchenko

Bogomolets National Medical University, 13 T. Shevchenko Blvd., Kyiv, 01601, Ukraine

THE USAGE OF RADIOFREQUENCY ABLATION FOR TREATMENT OF KELOIDS AND HYPERTROPHIC SCARS

Objective. To evaluate the effectiveness of radiofrequency ablation (RFA) for scars tissue volume reduction, and influence on the clinical manifestations of keloid and hypertrophic scars.
Materials and methods. Seventeen patients (9 males, 8 females), 19–62 years old, with some scars were enrolled into the prospective randomized controlled study: 10 with keloids, 7 with hypertrophic scars. Previous failed attempts to correct the scars were undertaken in 8 patients with keloids and in 3 patients with hypertrophic scars. The efficacy of four scar volume reduction methods was compared (12 scars in each group, 5 sessions at 10-day intervals): the first group – RFA, the second – intralesional 5-fluorouracil (5-FU) injections, the third – RFA followed by 5-FU injections and the fourth – RFA, injections of verapamil and then 5-FU.
Results. The scars volume reduction was faster after RFA (by 65.3 %) than after chemotherapy. Local verapamil application after RFA followed by 5-FU injections reduced scar volume after the fifth session by
78.3 %. Relieving of the associated symptoms and scars hyperaemia was faster after RFA than after cytostatic drug administration. Their simultaneous application, especially in combination with verapamil, intensified the effect. There were no infectious complications and haemorrhages. Ulcers 3–5 mm in diameter in the place of puncture on one scar in the first group, on two scars in the third and fourth groups were registered as the side effects. Seventeen scars in seven patients, who received RFA as a monotherapy or in combination with chemotherapy, were assessed 6 months after treatment. The average scars volume decreased from (3260.5 ± 2057.36) mm³ at the moment after the fifth session to (2110.6 ± 1296.16) mm³, p = 0.0033.
Conclusions. Scars volume reduction was faster after five sessions of RFA than following local 5-FU injections. Combination of RFA with scars infiltration with verapamil and 5-FU strengthened the effect. In the same way, the above-mentioned methods influenced clinical symptomatology associated with the scars. Scars hyperaemia was also reduced by RFA. Radiofrequency ablation of excess scar tissue is advisable to use as an initial method for the treatment of keloids and hypertrophic scars, since it is easy to carry, is not expensive and effectively reduces the scar volume, demonstrating the patient the opportunity to achieve a positive result.
Key words: keloids, hypertrophic scars, radiofrequency ablation, excess scarring, cytostatic drugs, verapamil.

Problems of Radiation Medicine and Radiobiology.
2019;24:561-573. doi: 10.33145/2304-8336-2019-24-561-573

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