Low Dose Insulin as an Anti-Scarring Therapy in Breast Surgery: A Randomised Controlled Trial

Background: The role of insulin in expediting wound healing is firmly established within the context of major trauma and burns however only limited clinical evidence exists as to its effects upon scar formation. This study aims to build upon previous laboratory work to examine the potential anti-scarring properties of insulin in a clinical environment. Methods: 91 patients undergoing bilateral aesthetic breast surgeries were recruited to receive low-dose insulin and placebo injections to the medial 3cm of their sub-mammary incisions within the context of a randomised, intra-patient, placebo controlled trial and scar quality was assessed at 3, 6, and 12-month reviews using the Manchester Scar Scale. Results: Across the cohort at 12-month review the insulin-treated scars had lower scar scores (p=0.055) compared to placebo. Sub-group analysis of individuals with heavier scars showed median scar scores were significantly lower for the insulin-treated scars in regards to both scar contour (p=0.048) and scar distortion (p=0.045). Conclusions: Sub-cutaneous insulin injections reduced the appearance of scarring in this study when compared to placebo. The greatest effect was seen in those participants who showed heavier scars and as such insulin has a role as an antiscarring therapy in individuals likely to be affected by heavier scarring. Further research is required to more precisely delineate what subjects may benefit most from this treatment. Acknowledgments: Jon Pleat. Director at Restore Burn & Research Foundation Di Lawrence-Watt. Emeritus Professor Brighton & Sussex Medical School Financial Disclosure Statement: None of the authors have anything to disclose and no funding was received for this article. Presented at: 2016 Winter BAPRAS meeting, London Trial Identification: South East Research Ethics Committee (REC reference 10/H1102/67). Corresponding Author:MJ Hallam, M.D, MRCS, BM, Department of Plastic Surgery, St John's Hospital, Livingston, Edinburgh, EH54 6PP, UK. mj_hallam@hotmail.co.uk ©2017American Society of Plastic Surgeons