T3 Randomized, Controlled, Within-patient, Single-blinded Study to Evaluate the Efficacy of Corticosteroid Injections for the Treatment of Hypertrophic Scar in Adult Burn Survivors
Notice bibliographique
Résumé
Abstract Introduction Intralesional corticosteroid injections (CSI) have become one of the cornerstone treatments of hypertrophic scar (HSc). However, the evidence is of limited-quality and published investigations have almost exclusively been performed in linear scars rather than hypertrophic burn scars. Thus, the aim of this study was to perform an appropriately powered, single-blinded, randomized controlled trial (RCT) to evaluate the impact of CSI on burn HSc compared to patient-matched control (C) scars. Methods Fifty burn survivors with 2 independent scars (separated by non-scarred skin preferably on the contralateral side or an anatomically similar site) were selected based on high-frequency ultrasound thickness (>2.034 mm to ensure that the site were outside of the range of normal scar). Baseline thickness measurements of the 2 sites were within 0.5 mm of each other, to ensure homogeneity and an erythema index >300 to establish they were immature HSc. The sites were randomly assigned to treatment (Tx) or C. The Tx HSc received a 10 mg/ml CSI. The CSI was repeated 6 weeks later and a 3rd final injection 6 weeks later if deemed necessary. Objective evaluation of thickness, pliability, erythema and melanin were obtained at the Tx and C sites at baseline, end of Tx and 6 weeks after the last injection. Thirty one participants completed the study, reaching the required number for an adequately powered sample based on pilot study data analyses. Results The mean number of injections per site was 2.1(±0.7 SD). An ANCOVA comparing the Tx vs C post-Tx, controlling for baseline and Fitzpatrick skin type, revealed a significant decrease (↓) in thickness and increase (↑) in pliability of the Tx compared to C HSc (p=0.0003), but no significant difference in erythema or melanin. Baseline to post-Tx comparisons using paired t-tests revealed significant ↓ in thickness of both the Tx and C HSc and ↑ in pliability of the Tx HSc during the Tx period, but no significant change in C HSc pliability or erythema. Wilcoxon Signed Rank Test revealed a significant ↑ in melanin of both Tx (p< 0.001) and C (p=0.0035) HSc. A regression model for repeated measures, controlling for baseline and skin type, revealed no significant change in thickness, pliability, erythema or melanin during the 6 week follow up. Conclusions Although HSc thickness ↓ at both the Tx and C site across time there was a significantly greater reduction at the CSI site and significantly greater ↑ in pliability. Melanin significantly ↑ at both the Tx and C site. There was no significant change during follow up of any of the HSc characteristics. Applicability of Research to Practice This well-controlled RCT demonstrated the benefits CSI for burn HSc thickness and pliability and the need for patient-matched C HSc.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,003 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».