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Tunneling technique for ease of intralesional injection in keloids
*Corresponding author: Rachita S. Dhurat, Department of Dermatology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India. rachitadhurat@yahoo.co.in
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Received: ,
Accepted: ,
How to cite this article: Bhangdiya DS, Dhurat RS, Sharma R. Tunneling technique for ease of intralesional injection in keloids. CosmoDerma 2023;3:70.
PROBLEM
Intralesional injections are the mainstay of the treatment for keloids. However, injecting through thick keloidal tissue is a challenge as a result of excessive proliferation of dermal fibroblasts and haphazardly arranged thick hyalinized collagen.
To overcome the difficulty of injection, clinicians use dermajet[1] to deliver intralesional drugs, although it is expensive and has deeper penetration. Another method of making keloid tissue soft is cryotherapy; however, it can give rise to bullae, ulceration, secondary infection, and dyspigmentation.[2]
SOLUTION
To soothe the process of injecting pharmacological agent into hard keloids, we propose that a 26G needle be inserted into keloid tissue and moved in a to and fro manner in different directions to create multiple tunnels. Thereafter, the intended drug is injected with ease owing to creation of these tunnels [Video 1]. A 26G needle was found to be suitable for tunneling [Figure 1].
Video 1:
Video 1:File demonstrating conventional injection technique followed by tunneling technique in keloid.
- Tunneling in keloids with 26G needle and 1 mL syringe.
This simple technique allows drug delivery into keloids with ease due to the tunnels created. On account of this, we have termed this technique as “tunneling technique.”
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest
There are no conflicts of interest.
Videos available online at
Financial support and sponsorship
Nil.
References
- Current trends in needle-free jet injection: An update. Clin Cosmet Investig Dermatol. 2018;11:231-8.
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- Keloids: Current and emerging therapies. Scars Burn Heal. 2020;6:2059513120940499.
- [CrossRef] [PubMed] [Google Scholar]
