Low-Dose Insulin as an Antiscarring Therapy in Breast Surgery: A Randomized Controlled Trial

Area of Science:

• Plastic Surgery
• Dermatology
• Wound Healing Research

Background:

• Insulin's role in wound healing is established, but its impact on scar formation is less understood.
• Limited clinical evidence exists regarding insulin's antiscarring properties.
• Previous laboratory work suggests potential benefits.

Purpose of the Study:

• To investigate the antiscarring properties of insulin in a clinical setting.
• To evaluate the effect of low-dose insulin injections on scar quality.
• To build upon existing laboratory findings in a human trial.

Main Methods:

• A randomized, intrapatient, placebo-controlled trial involving 91 patients undergoing bilateral aesthetic breast operations.
• Low-dose insulin and placebo were injected into submammary incisions.
• Scar quality was assessed using the Manchester Scar Scale at 3, 6, and 12 months.

Main Results:

• Insulin-treated scars showed lower overall scar scores compared to placebo at 12 months (p = 0.055).
• Subgroup analysis revealed significantly lower scar scores for insulin in scar contour (p = 0.048) and distortion (p = 0.045) among patients with heavier scars.
• A notable reduction in scar appearance was observed with insulin treatment.

Conclusions:

• Subcutaneous insulin injections effectively reduced scar appearance compared to placebo.
• Insulin demonstrates potential as an antiscarring therapy, particularly for individuals prone to heavier scarring.
• Further research is needed to identify specific patient subgroups who would benefit most from this treatment.