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Aesthetic Plastic Surgery
Published in: Aesthetic Plastic Surgery 2/2018

01-04-2018 | Original Article

Comparison of Enalapril, Candesartan and Intralesional Triamcinolone in Reducing Hypertrophic Scar Development: An Experimental Study

Authors: Canser Yilmaz Demir, Muhammet Eren Ersoz, Remzi Erten, Omer Faruk Kocak, Yilmaz Sultanoglu, Yildiray Basbugan

Published in: Aesthetic Plastic Surgery | Issue 2/2018

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Abstract

Background

The purpose of this study was to compare the effects of oral enalapril, an angiotensin-converting enzyme inhibitor (ACE-I), oral candesartan, an angiotensin receptor blocker (ARB), and intralesional corticosteroid treatments in reducing scar formation.

Methods

Twenty male rabbits were divided into five study groups: A (sham), B (control), C (ACE-I), D (ARB) and E (intralesional corticosteroid). The rabbit ear hypertrophic scar model was used. The hypertrophic scars were photographed and analyzed with the program ImageJ quantitatively to determine the degree of collagen fibers. The scar elevation index (SEI) was calculated at the end of the 40th day. Tissue samples were stained with hematoxylin and eosin and Masson’s trichrome and examined under light microscopy for the determination of fibroblast number, epithelization, vascularization, inflammation and fibrosis.

Results

The SEI was the highest in the control group with the highest number of fibroblasts under the epithelium. In the steroid group, the SEI was significantly lower than both the ACE-I (p: 0.02) and ARB (p: 0.001) groups. The density of type 1 collagen fibers was the lowest in the control group, whereas type 3 collagen fibers were highest in that group. The ACE-I and ARB groups were similar regarding densities of type 1 and type 3 collagen fibers. The density of type 1 collagen fibers was the highest in the steroid group, whereas the density of type 3 collagen fibers was the lowest in that group.

Conclusions

Enalapril, candesartan and intralesional steroid therapies were all effective in reducing scar tissue development; however, enalapril and steroid groups revealed better results.

No Level Assigned

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
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Metadata
Title
Comparison of Enalapril, Candesartan and Intralesional Triamcinolone in Reducing Hypertrophic Scar Development: An Experimental Study
Authors
Canser Yilmaz Demir
Muhammet Eren Ersoz
Remzi Erten
Omer Faruk Kocak
Yilmaz Sultanoglu
Yildiray Basbugan
Publication date
01-04-2018
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 2/2018
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-018-1073-6

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Acknowledgments

2017 Reviewer Thank You