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

To evaluate the effectiveness of radiofrequency ablation (RFA) for scars tissue volume reduction, and influence on the clinical manifestations of keloid and hypertrophic scars.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 inter- vals): 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.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.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 treat- ment of keloids and hypertrophic scars, since it is easy to carry, is not expensive and effectively reduces the scar vol- ume, demonstrating the patient the opportunity to achieve a positive result.Meta: otsinyty efektyvnist' vykorystannia radiochastotnoï abliatsiï (RChA) dlia zmenshennia ob’iemu rubtsevoï tkany- ny ta ïï vplyv na klinichni proiavy keloïdnykh ta gipertrofichnykh rubtsiv. Materialy i metody. Do prospektyvnogo randomizovanogo kontrol'ovanogo doslidzhennia zalucheno 17 patsiientiv (9 cholovikiv, 8 zhinok) vikom 19–62 roky z dekil'koma rubtsiamy: keloïdni – u 10 patsiientiv, gipertrofichni – u 7. Nevdali poperedni sproby korektsiï buly u 8 khvorykh z keloïdnymy rubtsiamy ta u 3 z gipertrofichnymy. Provedene porivniannia efektyvnosti chotyr'okh sposobiv zmenshennia ob’iemu rubtsevoï tkanyny (po 12 rubtsiv v kozhniy̆ grupi, p’iat' seansiv z 10-dennymy intervalamy): persha grupa – RChA, druga – mistsevi in’iektsiï 5-ftoruratsylu (5-FU), tre- tia – RChA z nastupnym vvedenniam 5-FU, chetverta – RChA, in’iektsiï verapamilu, potim 5-FU. Rezul'taty. Pislia RChA ob’iem rubtsiv zmenshuvavsia shvydshe (na 65,3%), nizh pislia khimioterapiï. Mistseve zastosu- vannia verapamilu pislia RChA, potim 5-FU zmenshuvalo ob’iem pislia p’iatogo seansu na 78,3%. Klinichna symptomaty- ka i giperemiia rubtsiv shvydshe prokhodyly pislia RChA, nizh pislia vvedennia tsytostatyka. Ïkh odnochasne zastosuvan- nia, osoblyvo v kombinatsiï z verapamilom, posyliuvalo efekt. Ne bulo infektsiy̆nykh uskladnen' ta krovotech. Z po- bichnykh efektiv zareiestrovani vyrazky diametrom 3–5 mm v mistsi punktsiï na odnomu rubtsi v pershiy̆ grupi, na dvokh rubtsiakh u tretiy̆ i chetvertiy̆ grupakh. V 6-misiachnyy̆ termin obstezheno 17 rubtsiv u 7 patsiientiv, iakym vykonana RChA iak monoterapiia abo v kombinatsiï z khimioterapiieiu. Seredniy̆ ob’iem rubtsiv zmenshyvsia z (3260,5 ± 2057,36) mm3 do (2110,6 ± 1296,16) mm3 na moment pislia p’iatogo seansu, p = 0,0033. Vysnovky. Pislia p’iaty seansiv RChA ob’iem rubtsiv zmenshuvavsia shvydshe, nizh pry mistsevomu vvedenni 5-FU, dodat- kova infil'tratsiia rubtsiv verapamilom ta 5-FU posyliuvala efekt. Analogichnym chynom perelicheni likuval'ni me- tody vplyvaly na klinichnu symptomatyku, zumovlenu rubtsiamy. Pislia RChA zmenshuvalas' giperemiia rubtsiv. Radio- chastotnu abliatsiiu nadlyshkovoï rubtsevoï tkanyny dotsil'no vykorystovuvaty iak initsial'nyy̆ metod likuvannia ke- loïdnykh i gipertrofichnykh rubtsiv, oskil'ky vona legko perenosyt'sia, nedoroga ta efektyvno zmenshuie ob’iem rub- tsia, demonstruiuchy patsiientu mozhlyvist' dosiagnennia pozytyvnogo rezul'tatu.