American Association of Plastic Surgeons

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Intra-lesional Collagenase Injection In Improving The Function And Texture Of Contracted Scar: An Innovative Minimal-invasive Treatment
Shuang-Bai Zhou, M.D., Ph.D., Bojun Tan, M.D., Ph.D., Kai Liu, M.D., Ph.D., Xie Yun, M.D., Ph.D., Qing-Feng Liu, MD., Ph.D..
Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.

PURPOSE: Contracted scar, that usually results in dysfunction and malposition, is a common disease in plastic surgery. Till now, limited efficacy of minimal invasive treatment can be achieved. Excessive pathologic collagen production is the cause of contracted scar. Collagenase has recently been approved for clinical application. We now report the effects of intralesional collagenase injection for the treatment of contracted scar.
METHODS: Twenty patients suffered from contracted scar were enrolled. Commercialized collagenase was diluted with sterile saline in the concentration of 600U/2ml and injected into the firm palpable cords of contracted scar, approximately 0.05ml/cm2. The treatment was repeated every 4 weeks for three times. All patients underwent physical therapy after treatment. The length of scar, skin texture and the joint movement was documented at 4, 8 and 12 weeks' follow-up. Safety of the collagenase treatment was also evaluated in this research.
RESULTS: In this research, enrolled scar location included neck, periocular area, lateral thigh, finger and palm. The contracted scar had an average maximal elongation of 29.1% from the baseline (7.1% to 43.2%). At 12 weeks-visit, 75% patients felt their scars as "significantly improved", defined as "better joint movement", "softened and flattened scar texture". The VISIA results also demonstrated the improvement in scar redness, indicating the alleviation of capillary proliferation. No severe adverse effects were experienced.
CONCLUSION: Intralesional injection of collagenase was effective in elongating the contracted scar. The treatment softened the scar and alleviated the redness. It may be suitable for patients that request functional improvement without surgical procedures.


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