Verapamil in conjunction with pressure therapy in the treatment of pathologic scar due burn injury

Guillermo Ramos-Gallardo; Ariel Miranda-Altamirano; Rebeca Valdes López; Sandra Figueroa-Jimenez; Leonel García-Benavides

2016, Number 4

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2016; 54 (4)

Verapamil in conjunction with pressure therapy in the treatment of pathologic scar due burn injury

Ramos-Gallardo G, Miranda-Altamirano A, Valdes López R, Figueroa-Jimenez S, García-Benavides L

Full text

How to cite this article

Language: Spanish
References: 26
Page: 454-457
PDF size: 265.94 Kb.

ABSTRACT

Background: Keloids and hypertrophic scars are dermal fibro-proliferative disorders unique to humans. Their treatment is a true challenge with multiple options, but not all the time with good results. Unfortunately this problem is not uncommon in patients with history of burn injury. The aim of this article is to evaluate the use of verapamil and pressure garments in patients with hypertrophic or keloid scar caused by burn injury.
Methods: We included patients with a hypertrophic or keloid scar caused by burn injury candidate to treatment with pressure garment. The pathologic scars were evaluated by serial photographic records, Vancouver and Posas scales. The scales of Vancouver and Posas were compared with t Student.
Results: We included 13 scars in 11 patients. Four scars were located in the legs, 4 in the arms, 4 in the face-neck and 1 in the abdomen. The dose of verapamil was calculated .03mg per kg. Injections were scheduled every 7 to 10 days until complete 6 sessions. Taking in count Posas scale, patients referred improvement in pigmentation (.01), thickness (.005), pliability (.01) and surface area (.004). In the Vancouver scale the observers mentioned improvement in elevation (.008), pigmentation (.014), vascularity (.022), flexibility (.014) and pruritus (.003). No adverse effects were found in verapamil injection.
Conclusions: Verapamil was useful in conjunction with pressure garment to improve the condition of the keloid and hypertrophic scar caused by burn.

REFERENCES

Atiyeh BS, El Khatib AM, Dibo SA. Pressure garment therapy of Burn Scars Evidence Based Efficacy. Annals of Burns and Fire Disaster 2013;26(4): 205-212.
Atiyeh BS, El Khatib AM, Dibo SA. Pressure garment therapy of Burn Scars Evidence Based Efficacy. Annals of Burns and Fire Disaster 2013;26(4): 205-212. 2. Anzarut A, Olson J, Singh P. The effectivenes of pressure garment therapy for the prevention of abnormal scarring after burn injury: A meta-analysis. J Plast Reconstr Aesthetic Surg, 2009;62:77-84. ..3. Engrav L.H., Heimbach D.M., Rivara F.P. 12 years within wound study of the effectiveness of custom pressure garment therapy. Burns 2010;36:975-983.
Boggio R.F., Freitas V M, Cassiola FM. Effect of a calcium-channel blocker (verapamil) on the morphology, cytoskeleton and collagenase activity of human skin fibroblasts. Burns 2011;37:616-625.
Lee, R. C., and Ping, J. A. Calcium antagonists retard extracel- lular matrix production in connective tissue equivalent. J. Surg. Res. 49:463,1990.
Doong H, Dissanayake S, Gowrishankar TR. Calcium antagonist alter cell shape and induce procollagenase synthesis in keloid and normal human dermal fibroblasts. J Burn Care Rehabil 1996;17 (6pt 1):497-514.
Giugliano G, Pasquali D, Notaro A. Verapamil inhibits intereukin-6 and vascular endothelial growth factor production in primary cultures of keloid fibroblast. Br J Plast Surg 2003;56(8):804-809.
Copcu E, Sivrioglu N, Oztan Y. Combination of surgery and intralesional verapamil injection in the treatment of the keloid. J Burn Care Rehabil 2004; 25(1):1-17.
D´Andrea F, Brongo S, Ferraro G, Baroni A. Prevention and treatment of keloids with intralesional verapamil. Dermatology 2002;204(1):60-62.
Lawrence, W. T. Treatment of earlobe keloids with surgery plus, adjuvant intralesional verapamil and pressure earrings. Ann. Plast. Surg. 37:167,1996.
Ahuja RB, Chatterje P. Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids. Burns 2014;40:583-588.
Shanti M, Dhanrah P. Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids. Indian J Dermatol Venereol Leprol 2008;74(4):343-348.
Ledon JA, Savas J, Franca K. Intralesional treatment for keloids and hypertrophic scars: a review. Dermatol Surg 2013;39(12):1745-1757.
Atiyeh BS, El Khatib AM, Dibo SA. Pressure garment therapy of Burn Scars Evidence Based Efficacy. Annals of Burns and Fire Disaster 2013;26(4): 205-212.
Atiyeh BS, El Khatib AM, Dibo SA. Pressure garment therapy of Burn Scars Evidence Based Efficacy. Annals of Burns and Fire Disaster 2013;26(4): 205-212. 2. Anzarut A, Olson J, Singh P. The effectivenes of pressure garment therapy for the prevention of abnormal scarring after burn injury: A meta-analysis. J Plast Reconstr Aesthetic Surg, 2009;62:77-84. ..3. Engrav L.H., Heimbach D.M., Rivara F.P. 12 years within wound study of the effectiveness of custom pressure garment therapy. Burns 2010;36:975-983.
Boggio R.F., Freitas V M, Cassiola FM. Effect of a calcium-channel blocker (verapamil) on the morphology, cytoskeleton and collagenase activity of human skin fibroblasts. Burns 2011;37:616-625.
Lee, R. C., and Ping, J. A. Calcium antagonists retard extracel- lular matrix production in connective tissue equivalent. J. Surg. Res. 49:463,1990.
Doong H, Dissanayake S, Gowrishankar TR. Calcium antagonist alter cell shape and induce procollagenase synthesis in keloid and normal human dermal fibroblasts. J Burn Care Rehabil 1996;17 (6pt 1):497-514.
Giugliano G, Pasquali D, Notaro A. Verapamil inhibits intereukin-6 and vascular endothelial growth factor production in primary cultures of keloid fibroblast. Br J Plast Surg 2003;56(8):804-809.
Copcu E, Sivrioglu N, Oztan Y. Combination of surgery and intralesional verapamil injection in the treatment of the keloid. J Burn Care Rehabil 2004; 25(1):1-17.
D´Andrea F, Brongo S, Ferraro G, Baroni A. Prevention and treatment of keloids with intralesional verapamil. Dermatology 2002;204(1):60-62.
Lawrence, W. T. Treatment of earlobe keloids with surgery plus, adjuvant intralesional verapamil and pressure earrings. Ann. Plast. Surg. 37:167,1996.
Ahuja RB, Chatterje P. Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids. Burns 2014;40:583-588.
Shanti M, Dhanrah P. Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids. Indian J Dermatol Venereol Leprol 2008;74(4):343-348.
Ledon JA, Savas J, Franca K. Intralesional treatment for keloids and hypertrophic scars: a review. Dermatol Surg 2013;39(12):1745-1757.