Rafath Basith Mahsa*, Jovic Goran, Chadwick Ngwisha and Alick Bwanga

Department of Surgery, University Teaching Hospitals, Lusaka, Zambia

*Corresponding Author: Rafath Basith Mahsa, Department of Surgery, University Teaching Hospitals, Lusaka, Zambia.

Received: September 01, 2022; Published: September 27, 2022

Abstract

Introduction: Keloid scarring is an abnormal healing response characterized by excessive localized scar tissue growth in response to skin trauma, burns, or infection, for which there is no standard treatment. It is extremely difficult to treat Keloids as surgery alone usually results in recurrence, however the use of Keloid excisions and intralesional injections of 5-fluorouracil has been proven effective worldwide; however, due to paucity of data in the African setting when it comes to the management of keloids and anecdotally, lots of recurrences have been observed. As a result, the purpose of this study was to determine the outcome of Keloid treatment with surgery followed by intralesional 5-FU with a 6-month follow-up at University Teaching Hospitals.

Methods: This was an observational Cohort study on 150 patients simple randomly sampled from the adult hospital at the University Teaching Hospitals. Once the patient had consented the clinician went ahead and performed the excision of smaller lesions of Keloid, under local anaesthesia. There after 5-FU was injected around the lesion 0.5-2ml of 50mg/ml and repeat dose of 5-FU was given weekly until 4 doses of 5-FU were administered. Patients were followed-up monthly using observer scale for 6 months. Ethical approval was granted from the University of Zambia Research Ethics Committee. To test the association and correlations, the chi-square test or Fischer’s exact test was carried out for categorical variables and for continuous variables, a t-test was used. Multiple regression was used when considering predictive effects of variables. A p-value of <0.05 at 95% CI was considered significant.

Results: The mean age in this study was 27.5 (6.2) years ranging from 18 to 46 years with nearly half (45.3%) of the study subjects falling between 26 to 35 years age group and 134 (89.3%) of the them were female. The study found that there was a 26.7% incidence rate of keloid recurrence at 6 months while the study identified itchiness (AOR = 2.949, 95% CI: 1.27 - 6.84, p = 0.012), steroid use (AOR = 2.52, 95% CI: 1.11 - 5.74, p = 0.028) and low platelet count (B = 0.001, t = 2.063, p = 0.041) as predictive of keloid recurrence.

Conclusion: The results of this study suggest that treatment of keloids with 5-FU following surgical excision improves the treatment outcomes by 73.3%. The study found that itching with subsequent pain as adverse effect of 5-FU injections, among patients especially in the female population and low platelet count increases the reoccurrence rate of keloids.

Keywords: Keloids; Recurrence; Treatment outcome; 5-Flourouracil; Excision

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Citation

Citation: Rafath Basith Mahsa., et al. “Outcomes of Keloid Excision and Intralesional 5-Flurouracil Injection in Adults at the University Teaching Hospital, Lusaka, Zambia". Acta Scientific Gastrointestinal Disorders 5.10 (2022): 28-36.

Copyright

Copyright: © 2022 Rafath Basith Mahsa., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.