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Hyaluronic Acid Accelerates VEGF and PDGF Release from Advance Platelet Rich Fibrin in Diabetic Foot Ulcer Ronald Winardi Kartika; Idrus Alwi; Franciscus Dhyanagiri Suyatna; Ferry Sandra; Em Yunir; Sarwono Waspadji; Suzzana Immanuel; Todung Silalahi; Saleha Sungkar; Jusuf Rachmat; Saptawati Bardosono; Mirta Hediyati Reksodiputro
The Indonesian Biomedical Journal Vol 13, No 3 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i3.1523

BACKGROUND: Hyaluronic acid (HA) is an essential component of extracellular matrix and mediates signaling in wound healing. HA could induce growth factor release from Advanced Platelet Rich Fibrin (A-PRF), including Vascular Endothelial Growth Factor (VEGF) and Platelet-derived Growth Factor (PDGF). However, concentrations of the released-VEGF and PDGF have not been clearly disclosed. Therefore, current study was conducted to measure the release of these growth factors in HA + A-PRF gel of diabetic foot ulcer (DFU) subjects.METHODS: Twenty DFU subjects were included in the study and treated with A-PRF or HA+A-PRF. A-PRF was derived from autologous peripheral blood and processed with low-speed centrifugation. HA was added with a ratio of 1:0.6. A-PRF or HA + A-PRF was applied topically on DFU. Upper tips of A-PRF or HA + A-PRF gels were collected on day 0, 3 and 7 for measurements of VEGF and PDGF concentrations with Enzyme-linked Immune-sorbent Assay (ELISA) methods.RESULTS: On day-3, both VEGF and PDGF concentrations of HA + A-PRF group were significantly higher than the VEGF (p=0.000) and PDGF (p=0.019) concentrations of A-PRF group. The VEGF and PDGF concentrations were continuously and significantly increased on day-7 of HA + A-PRF group, compared to the VEGF (p=0.000) and PDGF (p=0.004) concentrations of A-PRF group.CONCLUSION: Combination HA+A-PRF induces VEGF and PDGF release from A-PRF. A mixture of A-PRF and HA could be more effective than A-PRF alone for treatment of DFU.KEYWORDS: hyaluronic acid, advanced platelet rich fibrin, PRF, growth factor, VEGF, PDGF, diabetic foot ulcer

Advance-Platelet Rich Fibrin and Hyaluronic Acid Combination Improves Interleukin-6 and Granulation Index in Diabetic Foot Ulcer Patients Ronald Winardi Kartika; Idrus Alwi; Franciscus Dhyanagiri Suyatna; Em Yunir; Sarwono Waspadji; Suzanna Immanuel; Todung Silalahi; Saleha Sungkar; Jusuf Rachmat; Saptawati Bardosono; Mirta Hediyati Reksodiputro
The Indonesian Biomedical Journal Vol 13, No 2 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i2.1501

BACKGROUND: Diabetic foot ulcer (DFU) is the most common and threatening complication of Diabetes Mellitus (DM). Ideal wound dressing for DFU management should relieve symptoms, provide wound protection, and encourage healing. Advanced-Platelet Rich Fibrin (A-PRF) and Hyaluronic Acid (HA) have been proven to improve wound healing process. This study was aimed to demonstrate the ability of combination of A-PRF and HA in reducing inflammation and improving DFU tissue healing.METHODS: Twenty DFU subjects were involved in this study, and divided into two groups based on the topical fibrin gel treatment: A-PRF + HA group and A-PRF only group. A-PRF was obtained by peripheral blood centrifugation. A-PRF + HA was prepared by homogening A-PRF and AH with a ratio of 1:0.6. Interleukin-6 (IL-6) level, granulation index (GI), numeric pain score (NPS), and inflammation clinical symptoms (ICS) were assessed on day-0, 3, 7 and 14.RESULTS: Wound swabs’ IL-6 level on day-7 was found to be significantly lower in A-PRF + HA compared to A-PRF alone (p=0.041). The IL-6 level reduction also found to be significant higher either in wound swabs (day 0-7, p=0.015) or fibrin gel (day 0-3, p=0.049; day 0-7, p=0.034). A-PRF + HA treatment significantly increased the GI even since day-3 (p=0.043), with lower NPS (p<0.001), and ICS score.CONCLUSION: The combination of A-PRF and HA increases the GI in DFU healing by reducing the inflammation state which will induce the angiogenesis process, as well as reducing pain in DFU subjects better than A-PRF alone.KEYWORDS: inflammation, interleukin-6, wound healing, angiogenesis, proliferation

Noma: a neglected tropical disease Mirta Hediyati Reksodiputro; Mikhael Yosia
Oto Rhino Laryngologica Indonesiana Vol 51, No 1 (2021): Volume 51, No. 1 January - June 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i1.429

Background: Noma is an orofacial gangrene often manifesting in malnourished children in developing and tropical countries. Epidemiological data on noma are hard to find, but it is estimated that the global incidence of noma is 30-40,000 cases per year, with estimated mortality rate of about 85%. Purpose: To discuss the pathogenesis, diagnosis, prevention, and treatment of noma. Literature review: The cause of noma is multifactorial, but is often found in conjunction with malnutrition and with other diseases such as measles, malaria, and the human immunodeficiency virus (HIV), along with poor oral hygiene. The pathogenesis of noma includes a rapidly spreading noninfectious gangrene infection of the face, often preceded by acute necrotizing gingivitis, and stomatitis. Microbiological studies show opportunistic infections caused by imbalance of normal intraoral microorganisms. The key to prevention is to increase food hygiene, improving vaccination program against measles, prevention of malaria and HIV, and early detection and treatment of necrotic gingivitis and stomatitis. Early treatment with antibiotics can prevent gangrene formation or reduce the extent of the lesions. Late treatment consists of surgical rehabilitation, which is often hard to conduct. Conclusion: Noma is an infectious disease that can cause wide gangrenous wounds. Recognizing and understanding the symptoms and characteristic signs of noma is important so that comprehensive prevention and management can be given as early and optimally as possible to provide complete recovery for patients.ABSTRAK Latar belakang: Noma adalah gangren orofasial yang menyerang anak-anak kekurangan gizi terutama di negara-negara berkembang dan negara-negara tropis. Data epidemiologi tentang noma sangat langka, tetapi perkiraan kejadian global saat ini adalah 30-40.000 kasus per tahun, dengan tingkat kematian sekitar 85%. Tujuan: Membahas patogenesis, diagnosis, pencegahan, dan tatalaksana noma. Tinjauan pustaka: Penyebab noma multifaktorial, namun sering ditemukan bersamaan dengan malnutrisi dan dengan penyakit lain seperti campak, malaria, dan human immunodeficiency virus (HIV). Sering pula terjadi bersamaan dengan higiene mulut yang buruk. Patogenesis noma meliputi infeksi gangren tidak menular, yang menyebar cepat di daerah wajah, sering didahului oleh gingivitis nekrotikans akut, dan stomatitis. Studi mikrobiologi menunjukkan adanya infeksi oportunistik yang disebabkan oleh ketidakseimbangan mikroorganisme intraoral normal. Pencegahan dapat berupa nutrisi yang baik, vaksinasi campak, pencegahan malaria dan HIV, termasuk deteksi dini dan pengobatan gingivitis nekrotikans dan stomatitis. Pengobatan dini dengan antibiotik dapat mencegah terjadinya gangren atau mengurangi luasnya lesi. Perawatan lebih lanjut berupa rehabilitasi bedah, yang seringkali tidak mudah dilakukan. Kesimpulan: Noma adalah penyakit infeksi yang dapat menimbulkan defek luka gangren luas. Penting untuk mengenali dan memahami gejala serta tanda karakteristik noma, sehingga pencegahan dan tatalaksana secara komprehensif dapat diberikan sedini dan seoptimal mungkin, agar dapat memberikan kesembuhan sempurna untuk pasien.Kata kunci: noma, penyakit tropik terabaikan, gangren orofasial, gingivitis nekrotik akut

Penatalaksanaan fraktur simfisis mandibula dengan dua perpendicular mini-plates Mirta Hediyati Reksodiputro; Noval Aldino
Oto Rhino Laryngologica Indonesiana Vol 47, No 2 (2017): Volume 47, No. 2 July - December 2017
Publisher : PERHATI-KL

Latar belakang: Fraktur mandibula merupakan salah satu fraktur daerah wajah yang paling sering terjadi. Penatalaksanaan kasus fraktur mandibula membutuhkan pemahaman secara komperehensif meliputi faktor anatomi, biomekanik, dan oklusi. Ketiga faktor tersebut bertujuan untuk mengembalikan fungsi mandibula yang sangat bergantung pada posisi anatomis fragmen tulang, dengan morbiditas seminimal mungkin. Plate and screw telah digunakan selama beberapa dekade terakhir untuk memfasilitasi stabilitas fragmen tulang di daerah maksilofasial, dan sampai saat ini merupakan teknik yang paling sering digunakan. Tujuan: Memahami prinsip penatalaksanaan kasus fraktur simfisis mandibula menggunakan 2 perpendicular mini-plates. Kasus: Dilaporkan laki-laki, berusia 24 tahun dengan fraktur multipel wajah (fraktur komplit simfisis mandibula, fraktur sagital palatum, dan fraktur rima orbita inferior) akibat kecelakaan lalu lintas. Metode: Pencarian literatur dilakukan melalui Cochrane, Pubmed, ClinicalKey, dan Wiley dalam kurun waktu 5 tahun terakhir. Berdasarkan kriteria inklusi dan eksklusi, didapatkan satu artikel yang telah dilakukan critical appraisal. Hasil: Dari 25 pasien dengan fraktur mandibula, semua pasien dilakukan tindakan open reduction diikuti dengan penggunakan fiksasi 2 mini-plates. Penatalaksanaan yang dilakukan untuk fraktur mandibula pada kasus ini adalah open reduction internal fixation (ORIF) menggunakan 2 perpendicular mini-plates, dan pemasangan intermaxillary fixation (IMF), serta maxillo-mandibular fixation (MMF) untuk menjaga stabilitas tulang, guna mendukung proses osifikasi pada fraktur palatum. Kesimpulan: Penggunaan dua buah plate and screw pada simfisis mandibula, dengan kombinasi MMF dan IMF selama 4 minggu berhasil memberikan hasil oklusi yang baik dengan komplikasi seminimal mungkin. Kata kunci: Fraktur mandibula, ORIF, MMF, IMF, perpendicular mini-plates ABSTRACT Background: Mandible fracture is one of the most common fractures in facial region. Management of mandible fractures a comprehensive knowledge about anatomical, biomechanic and occlusion factors. These factors are essential to normalize the mandible function with minimal morbidity, and it very much depends on its bone fragments anatomical position. Plate and screw have been used for decades to facilitate the stability of bone fragments in maxillofacial region, and nowadays is still frequently used technique. Objective: Understanding the principal management of mandibular symphysis fracture using two perpendicular mini-plates. Case: A 24 year-old male presented with multiple facial fractures due to traffic accident (mandibular symphysis complete fracture, sagital palatum fracture and inferior orbital rim fracture). Method: Literature study was conducted through Cochrane, Pubmed, ClinicalKey, and Wiley within last 5 years. An article has been retrieved based on the critical appraisal that was subjected to exclusion and inclusion criteria. Results: Among 25 patients with mandibular fractures, surgical procedures were performed through open reduction and internal fixation with the use of 2 mini-plates. Open reduction internal fixation (ORIF) using 2 perpendicular mini-plates was performed, followed by installation of intermaxillary fixation (IMF), and maxillo-mandibular fixation (MMF), to maintain bones stability that was needed to support ossification process of sagital palatal fracture. Conclusion: Management of mandibular fracture using two perpendicular mini-plates upon mandibular symphysis, by combining MMF and IMF for 4 weeks, was successful to obtain a good occlusion with a minimal complication. Keywords: Mandible fractures, ORIF, MMF, IMF, 2 perpendicular mini-plates

Management of Presbyphonia Fauziah Fardizza; Mirta Hediyati Reksodiputro
Oto Rhino Laryngologica Indonesiana Vol 50, No 1 (2020): Volume 50, No. 1 January - June 2020
Publisher : PERHATI-KL

Background: The proportion of individuals over 65 years of age in developed countries is increasing rapidly, due in large part to current and projected increases in life expectancy.Within the aging population, the incidence of vocal disorders is estimated to be between 12%-35%. Literature Review: Presbyphonia, or age-related dysphonia, is a diagnosis of exclusion. Patients’ other comorbidities must be evaluated completely. The complexity of presbyphonia involves the changes in the diverse tissues of the true vocal folds, musculature, and cartilage. Patients would get benefit from treatment of voice therapy or surgical laryngeal augmentation procedures. Purpose: The aim of this literature review is to describe presbyphonia and several kinds of its management. The primary treatment goal is to enhance glottal closure either by voice therapy or surgical interventions (phonosurgery) such as injection augmentation (IA) and bilateral thyroplasty surgery (BTS). Holistic physical evaluation had to be done to reach complete medical therapy. Conclusion: The best therapy for presbyphonia are voice therapy, or surgery followed by voice therapy and voice hygiene.Keywords: vocal disorder, presbyphonia, voice therapy, phonosurgery, management ABSTRAKLatar belakang: Prevalensi individu yang berusia diatas 65 tahun di negara maju semakin meningkat dengan cepat seiring dengan meningkatnya usia harapan hidup. Dalam populasi lanjut usia, angka kejadian gangguan fonasi diperkirakan antara 12%-35%. Tinjauan Pustaka: Presbifonia, atau disfonia terkait usia lanjut, membutuhkan evaluasi faktor komorbid secara lengkap. Kerumitan dari presbifonia adalah karena melibatkan perubahan jaringan, otot, dan tulang rawan di sekitar pita suara. Tatalaksana yang dilakukan adalah perawatan terapi suara dan prosedur bedah augmentasi pita suara. Tujuan: Untuk menggambarkan presbifonia serta berbagai jenis tatalaksananya. Keberhasilan utama penatalaksanaan presbifonia adalah meningkatnya penutupan glotis, baik dengan terapi suara atau intervensi bedah (phonosurgery) seperti injeksi augmentasi dan bedah tiroplasti bilateral. Dibutuhkan evaluasi fisik secara holistik untuk mencapai hasil terapi medis yang baik. Kesimpulan: Penatalaksanaan terbaik untuk presbifonia adalah terapi suara, atau pembedahan diikuti dengan terapi suara dan higiene suara.

Association Between Active or Passive Smoking and Allergic Rhinitis: an Evidence-Based Case Report: Smoking and Allergic Rhinitis Lupita Reksodiputro; Thalia Mufida; Niken Poerbonegoro; Mirta Hediyati Reksodiputro
eJournal Kedokteran Indonesia Vol 9, No. 1 - April 2021
Publisher : Faculty of Medicine Universitas Indonesia

This evidence-based case report (EBCR) aims to investigate the association between active or passive smoking with allergic rhinitis by summarizing existing studies on the topic. A literature search was done on major databases with keywords related to this study’s research question. The literature was appraised using CEBM University of Oxford for etiology study and systematic review sheets. The search obtained two articles for critical appraisal, includes a meta-analysis and a cohort study. The studies were appraised as valid, important, and applicable to the writer’s setting. Saulyte et al’ s2 article described RR active smoking with allergic rhinitis of 1.02 (95%CI 0.92-1.15), with no significant association. They resolved the heterogeneity by making subgroups. The cross-sectional subgroup with RR 1.09 (95%CI 1.06-1.12) is statistically significant. There was a significant association in passive smoking and obtained RR 1.10 (95%CI 1.06-1.15). In the study by Mlinaric et al4 the RR of active and passive smoking compared to non-smoker are 1.82 and 2.00; both show statistical significance. Both active and passive smoking is associated with a high risk of allergic rhinitis in adults and children. Keywords active smoking, passive smoking, allergic rhinitis. Hubungan Perokok Aktif dan Pasif dengan Rhinitis Alergi: Laporan Kasus Berbasis Bukti Abstrak Pada laporan kasus berbasis bukti ini bertujuan untuk menginvestigasi hubungan antara perokok aktif dan perokok pasif pada pasien dengan rinitis alergi. Dilakukan pencarian literatur menggunakan kata kunci yang berhubungan dengan kasus pada beberapa search engine, kemudian dilakukan penilaian kelayakan dengan lembar appraisal dari CEBM University of Oxford for etiology study and systematic review sheet. Dari pencarian didapatkan dua artikel yang mepresentasikan kasus tersebut, yaitu studi meta analisis dan studi cohort. Studi meta analisis oleh Saulyte et al2 menyatakan RR pada perokok aktif dengan rinitis alergi adalah 1,02 (95%CI 0,92-1,15). Pada subgrup potong lintang didapatkan perbedaan bermakna dengan RR 1,09 (95%CI 1,06-1,12). Pada studi cohort oleh Minaric et al didapatkan RR pada perokok aktif 1,82 dan pada perokok pasif 2,00, keduanya menunjukan angka yang signifikan. Pada perokok aktif dan pasif berhubungan dengan risiko tinggi pada rinitis alergi di pasien dewasa dan anak-anak. Kata kunci: perokok aktif, perokok pasif, rhinitis alergi.

Retroauricular Advancement Flap In Single Stage Auricular Defect Reconstruction Mirta Hediyati Reksodiputro; Trimartani Koento; Dwi Wahyu Manunggal
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Auricular defects must be treated early and properly because they may interfere with facial symmetry. Retroauricular skin is an ideal flap source for a non-reduction reconstruction procedure of the upper, middle, and lower auricular defects. Auricular reconstruction aims to achieve good anthropometric and aesthetic ear unit. The purpose of this case report is to present a reconstruction of auricular defects using the rectroauricular flap that results in a favorable aesthetic and normal anthropometric dimensions of the auricular. We report a case of auricular defect caused by post-excision of keloid located in the helical and antithetical area of the middle third of the right auricular, using a retroauricular flap. Normal values of the auricular’s anthropometric measurements were achieved, followed by a complete aesthetic ear unit. Retroauricular flaps are suitable for reconstructing partial auricle defects in the helical rim, temporal area, and conchae. Keywords: auricular defect, retroauricular flap, aesthetic ear unit, auricular anthropometry. Jabir Retroaurikular untuk Rekonstruksi Defek Telinga Abstrak Daun telinga berperan penting pada simetri wajah sehingga defek di daun telinga harus ditangani dengan baik sejak dini. Kulit retroaurikular merupakan sumber jabir ideal untuk rekonstruksi tanpa reduksi pada defek daun telinga bagian atas, tengah, dan bawah. Rekonstruksi daun telinga bertujuan untuk mendapatkan hasil yang baik secara antropometri dan estetika unit telinga. Tujuan laporan kasus ini adalah menunjukkan hasil yang baik berdasarkan unit telinga estetik dan dimensi normal antropometri pada rekonstruksi defek daun telinga menggunakan jabir rektroaurikular. Dilaporkan satu kasus defek telinga pasca-eksisi keloid, di area heliks dan antiheliks sepertiga tengah daun telinga kanan, menggunakan jabir retroaurikular. Didapatkan nilai normal pada pengukuran antropometri telinga dan kelengkapan estetika unit telinga. Jabir retroaurikular baik untuk rekonstruksi defek telinga parsial di lengkung heliks, area temporal, dan konka. Kata kunci: defek aurikular, jabir retroaurikular, unit telinga estetik, antropometri daun telinga.

Outcomes of Autologous Reconstruction in Comparison with Alloplastic in Microtia Patients Dini Widiarni Widodo; Irfan Irfan; Eka Dian Safitri; Mirta Hediyati Reksodiputro
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.178.258-64

Background: Microtia is a congenital abnormality of the auricle. One of the important comprehensive management of microtia is ear reconstruction. Reconstruction using an auricle framework from autologous material originating from the rib cartilages is still the gold standard. However, currently, some surgeons prefer alloplastic materials which are claimed to reduce morbidity and can be performed at a younger age. Objective: Report a case of a microtia patient who underwent autologous reconstruction followed by a literature search comparing the outcomes of autologous and alloplastic reconstruction. Case: An 11-year-old with grade 3 unilateral microtia who underwent autologous reconstruction surgery using materials from the rib cartilages. Later he complained of pain at the rib grafting site, more than at the surgical wound in the ear. Methods: A literature search based on the clinical question was done in PubMed, EBSCOhost, Cochrane Library, and by hand searching. Results: Three relevant articles that fit the clinical question were included. Autologous reconstruction causes fewer complications, while alloplastic reconstruction is better aesthetically. Further research is needed regarding the quality of life. Conclusion: Auricular reconstruction using autologous material remains the superior material of choice. Alloplastic framework can be an alternative choice with better aesthetic results but greater complication risk.

Analysis of Internal Nasal Valves Shapes and Angle due to Nasal Obstruction in Asian Nose Tiara Melati; Mirta Hediyati Reksodiputro; Trimartani Koento; Sandi Iljanto
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.203.212-8

BACKGROUND Internal nasal valve (INV) is widely discussed because it is believed to have a role in structural nasal obstruction. Caucasian has a rather acute angle of INV due to the known geometric of their nose. Whilst Asian generally has broader, thicker, and bigger anthropometric proportion of nose than Caucasian. Asia is vastly diverse in ethnicity, one can only assume that Asian INV may be differ in shape and larger in angles compare to Caucasian, due to the minimum publication addressing this issue. AIM To report the anatomy of INV and its angle in obstructed Asian noses. METHOD A case control study was conducted. Forty cases of nasal obstruction and 80 controls without nasal obstruction. Both groups were evaluated using Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, rigid nasal endoscopy and active anterior rhinomanometry (AAR). Anatomy and angle of INV was later measured using digital image analysis. RESULT Six basic INV shapes were seen throughout both groups, many has different shape combinations. Most commonly (more than 60%) observed shape in both groups were the occupied by nasal septal body (NSB). The right INV angle in case group was 15,5º ± 10,1º (p = 0,123) and left INV angle was 17,2º ± 9,0º (p = 0,022). In control group, the right INV angle was 19,6º ± 11,8º (p = 0,123) and left INV angle was 23,2º ± 12,5º (p = 0,022). CONCLUSION It is shown that most common shape of Asian INV in both groups, is the occupancy by NSB. Internal nasal valve angle in obstructed nose is narrower in comparison to those without nasal obstruction. This study also demonstrates Asian, particularly Indonesian, has a wider angle than Caucasian.

Eksisi Intralesi sebagai Strategi Tatalaksana Keloid: Laporan Kasus Berbasis Bukti Trmartani; Widodo, Dini Widiarni; Ranakusuma, Respati Wulansari; M, Mesiwisani; Putri, Annisa; Reksodiputro, Mirta Hediyati
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 1 (2024): VOLUME 54, NO. 1 JANUARY - JUNE 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i1.646

Background: Several therapeutic modalities exist for keloids, but management them remains a challenge due to high recurrence rates. These case series discussed surgical therapy using intralesional excision. Purpose: To compare the effect of intralesional excision with extra-lesional excision followed by post-operative triamcinolone injection, on the recurrence rates of auricular keloids. Case reports: Three patients with keloids treated with intralesional excision were presented. The first patient, a 20-year- old male, had keloids on both ears, nose, hands, and feet following burnt injury. The second patient, a 19-year-old female, had a keloid lump on the left auricle. The patient had a history of bilateral microtia and had undergone stage 1 auriculoplasty with rib grafting on both ears. The third patient, a 36-year-old woman with complaints of a keloid appearing for 3 years in the helix of her right ear, and underwent surgical excision followed by triamcinolone injection. Clinical question: How does the recurrence in patients with auricular keloid undergoing intralesional excision and postoperative triamcinolone injection, compared to extra-lesional excision and triamcinolone injection? Method: A systematic literature search was conducted using PubMed, Cochrane Library, Scopus, and ClinicalKey with relevant keywords: “intralesional excision”, AND “keloid”. Result: A total of 192 articles were found, and 3 articles met the eligibility criteria. Conclusion: The literature search revealed no difference in the recurrence rates between intralesional and extra-lesional excision with triamcinolone injection. Further research on this topic is needed. Keywords: intralesional excision, keloid, recurrence

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