At follow-up 4 weeks later, the incision was clean, dry, and intact with no erythema or induration (Fig. 4). No keloid reformation occurred on subsequent 4- and 9-month follow-ups, at which point the scar was minimally visible and the patient pleased with the aesthetic results.
First-line treatment in the United States is typically corticosteroids, which matches international expert guidelines.10–12 Monotherapy is often inadequate, however. Reported recurrence rates with steroids alone range from 9% to 50% but were found to decrease to 14.3% when combined with surgical resection.3,13 Similarly, improved results with multimodal therapy were found combining surgery and irradiation, steroids and fluorouracil (5-FU), and so on.1,3,10,11,14,15 Of note, many of these protocols require repeated interventions, such as monthly injections of steroids or botulinum toxin.1,11
Ongoing research into the inflammatory mechanisms of keloid formation and clinical treatments has yet to find a durable solution. Within the literature and practice, there is an ongoing search for novel therapies with the hope of decreasing recurrence rates and ultimately preventing initial formation of keloids.
This case report is a proof of concept for use of vCPM in the treatment of fibroproliferative scar formation in conjunction with surgery. Though findings are limited as a case study, this novel approach is promising, and further clinical research is warranted.
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