Efficacy of triamcinolone acetonide combined with botulinum toxin A in the treatment of hypertrophic scars and keloids: A meta-analysis.

[BACKGROUND] This meta-analysis aims to evaluate the efficacy and safety of triamcinolone acetonide (TCA) combined with botulinum toxin type A (BTA) for treating hypertrophic scars and keloids.

[METHODS] A comprehensive search of randomized controlled trials published before September 2023 was conducted across the Cochrane Library, Embase, PubMed, Web of Science, and CNKI databases. The analysis involved calculating pooled weighted mean difference (WMD), pooled risk ratios (RR), and 95 % confidence intervals (CI).

[RESULTS] Inclusive of 11 studies with a total of 561 patients, the meta-analysis revealed a statistically significant difference in the effective rate between the BTA+ TCA and control groups (RR = 1.28, 95 % CI = 1.14-1.44). Moreover, BTA+ TCA demonstrated a significant improvement in Visual Analog Scale scores (WMD = -1.69, 95 % CI = -2.72 - -0.66) and Vancouver Scar Scale scores (WMD = -1.46, 95 % CI = -1.90 - -1.02) compared to the control group. However, no statistically significant difference in scar thickness was observed between the BTA+ TCA and control groups (WMD = -0.11, 95 % CI = -0.30 - 0.09).

[CONCLUSION] This meta-analysis showed that the combined use of BTA and TCA demonstrates high effectiveness in scar treatment, but its influence on scar thickness is limited. Future research should further explore the sources of heterogeneity and validate the long-term effects and safety of this therapy.