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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2015 October 66(5):189-95
5% lidocaine medicated plaster in the treatment of painful scars after hand surgery
Area Ortopedica, Presidio Sanitario Intermedio Napoli Est, Napoli, Italia
AIM: Hypertrophic scars, or keloids, after hand surgery are a common cause of localized neuropathic pain due to injury to the sensitive cutaneous nerves during the procedure, with formation of small neuromas. 5% lidocaine medicated plaster is the recommended topical treatment of localized neuropathic pain, to reduce the excitability of peripheral A delta and C or dysfunctional nerve fibers. In this retrospective study we evaluated the effectiveness of 5% lidocaine medicated plaster in the treatment of painful scars.
METHODS: We reviewed the clinical charts of 22 surgical patients attending our outpatient clinic between March 2014 and February 2015.
RESULTS: At the first control visit, about 16 days on average after the start of therapy, pain intensity improved significantly (P<0.01 vs. baseline) and then gradually resolved during the observation period, as did mechanical allodynia. Assessment of treatment satisfaction and improvement in sleep quality indicated that the lidocaine plaster is effective in relieving pain and generally well tolerated, except for one case of mild erythema which regressed spontaneously without requiring suspension of therapy.
CONCLUSION: Our results suggest that, because of its proven effectiveness and tolerability, application of 5% lidocaine medicated plaster is a valid choice in the treatment of localized neuropathic pain caused by painful scars.