Clinical study on optimizing 5-fluorouracil and triamcinolone acetonide combination therapy for non-auricular small keloids using 24 MHz high-frequency ultrasound guidance

LI Yuting; WEI Antao; LI Hong; CHEN Bolin; ZHAO Pengyu; WANG Song; LIAO Zhonghai

doi:10.3969/j.issn.1673-7040.2025.11.009

Abstract：Objective To explore the appropriate drug concentration of 5-fluorouracil combined with triamcinolone acetonide in the treatment of non-ear small keloids with 24 MHz high-frequency ultrasound-assisted evaluation.Methods A prospective randomized controlled study was conducted on 60 patients with non-auricular small keloids who were admitted to the Medical Aesthetic Center of Chengdu Second People's Hospital from December 2022 to December 2023.According to the random number table method,20 cases were divided into low concentration group,medium concentration group and high concentration group,and different concentrations of 5-fluo-rouracil(0.5 mg/ml,2.3 mg/ml,5.0 mg/ml)combined with triamcinolone acetonide(10.0 mg/ml)were used for local injection.The scar vol-ume parameters and blood flow signals were collected by 24 MHz high-frequency ultrasound,and the blood flow signals in keloids were quantitatively evaluated according to the blood flow grading method,and the scar volume,blood flow grade,Vancouver scar scale(VSS)score,adverse reactions,and recurrence after one year of follow-up after the last treatment were compared between the three groups before treatment and 4 weeks after the last treatment.Results Compared with before treatment,4 weeks after the last treatment,the scar volume of the three groups decreased,the blood flow grade decreased,and the VSS score decreased,and the differences were statistically signifi-cant(P＜0.05).Compared with the low concentration group,the scar volume and VSS score of the patients in the medium concentration group and the high concentration group decreased respectively,and the blood flow grade of the high concentration group decreased statisti-cally significant(P＜0.05).Compared with the medium concentration group,the scar volume and VSS score of the patients in the high con-centration group decreased(P＜0.05).There was no significant difference in the incidence of adverse reactions between the three groups(P＞0.05).At one year of follow-up after the end of the last treatment,there was no significant difference in the recurrence rate of keloids between the three groups(P＞0.05).Conclusion 24 MHz high-frequency ultrasound,as an auxiliary evaluation tool,can quantify the vol-ume parameters of the scar,monitor the blood flow signal in the scar,and provide an objective basis for the treatment and evaluation of keloids,which is a promising evaluation method,and the high-concentration 5-fluorouracil combined with triamcinolone acetonide in the treatment of non-ear small keloids has better clinical effects,the scar volume and blood flow signal are significantly improved,there are no obvious adverse reactions,and the clinical efficacy is safe and reliable.