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Comparison of Keloid Volume and Symptoms Reduction Between Intralesional Umbilical-Cord Mesenchymal Stem Cells, Its Conditioned Medium, and Triamcinolone Acetonide Injection as Keloid Therapy: A Randomised Controlled Trial

Phase 4
Completed
Conditions
Stem Cell
Keloid
Interventions
Biological: umbilical cord-derived mesenchymal stem cells (UC-MSC)
Biological: umbilical cord-derived mesenchymal stem cells conditioned medium (UC-CM)
Registration Number
NCT05887804
Lead Sponsor
Rumah Sakit Pusat Angkatan Darat Gatot Soebroto
Brief Summary

This study is a double-blind randomized controlled trial (RCT) examining the effect of intralesional injection of umbilical cord-derived mesenchymal stem cells (UC-MSC), umbilical cord-derived conditioned medium (UC-CM), or triamcinolone acetonide (TA) on keloids carried out using CONSORT statement. Research is directed at studying keloid volume reduction and changes in POSAS score.

Detailed Description

Patients were screened initially by measuring the length and thickness of the keloids using a ruler. Patients who met the study inclusion criteria were randomly divided into three groups. Each patient in the groups was given the same injection volume (1 mL) in every cm3 keloid volume using a 1 mL syringe and 27G needle. The injections were ultrasound-guided into the center of the lesion with a 30-45-degree angle using an in-plane technique, therefore the same pressure. Group 1 was given umbilical cord-derived mesenchymal stem cells (UC-MSC) 2 million cells/mL/cm3, group 2 was given umbilical cord-derived conditioned medium(UC-CM) 1 mL/cm3, and group 3 was given triamcinolone acetonide (TA) 40 mg/mL/cm3. All patients received a single dose and 1 booster dose. The percentage of keloid volume regression in each treatment group was calculated by calculating the difference in volume before and after therapy with a 3-dimensional CT-scan, then expressed as a percentage. The CT-scan volume was obtained with the SmartVitrea application (Figure 2), then a POSAS examination will be carried out for subjective and objective assessment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria
  • The patient has keloids with a length of 2-10 cm and a thickness of 3-5 mm located on the chest, back, abdomen and extremities
  • Patients aged 18 - 55 years
  • Post-surgery patients more than 3 months that cause keloids
  • The patient is willing to fill in the informed consent form
Exclusion Criteria
  • Patients with hypertrophic scars
  • History of kidney failure
  • Hypertension
  • Pregnant and breastfeeding
  • History of blood disorders
  • History of tumor or malignancy
  • Get other keloid therapy outside of the research procedure

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
triamcinolone acetonideTriamcinolone Acetonide (TA)group 3 was given TA 40 mg/mL/cm3
umbilical cord-derived mesenchymal stem cells (UC-MSC)umbilical cord-derived mesenchymal stem cells (UC-MSC)UC-MSC was collected in 50 mL of transport medium, which contained alpha minimal essential medium (αMEM \[GIBCO 12000-0221\]), penicillin/streptomycin (final concentration 300u/mL \[GIBCO 15140-122\]) and amphotericin B (final concentration 7500ng /mL \[JR Scientific 50701\]), and processed in less than 8 hours after collection. Group 1 was given UC-MSC 2 million cells/mL/cm3
umbilical cord-derived mesenchymal stem cells conditioned medium (UC-CM)umbilical cord-derived mesenchymal stem cells conditioned medium (UC-CM)group 2 was given UC-CM 1 mL/cm3
Primary Outcome Measures
NameTimeMethod
Keloid volume reduction15 weeks

Volume was measured by CT-scan 2 weeks and 17 weeks after the first visit

The Patient and Observer Scar Assessment Scale (POSAS) score reduction17 weeks

Symptoms were measured using The Patient and Observer Scar Assessment Scale (POSAS) on the first visit, five weeks, 13 weeks, and 17 weeks after the first visit. Each item of the POSAS is rated on a 10-point score. The lowest score is '1', corresponding to the normal skin situation (i.e., normal pigmentation, no itching). Score 10 equals the most significant difference from normal skin (i.e., the worst imaginable scar or sensation). The symptoms are considered improved if the score gets lower. The total score of both scales can be calculated by summing up the scores of each of the six items. The total score can range from 6 to 60.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

RSPAD Gatot Soebroto

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Jakarta Pusat, DKI Jakarta, Indonesia

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