Abstract Introduction: It is well known that keloids are “Confused scars that do not know when to stop growing”. The basic pathology is an imbalance between anabolic (proliferation) and catabolic (apoptotic) phases of the healing process. The various treatment modalities so far described in managing keloids aresurgical excision, intraregional steroidal injections, compression therapy with silicon sheets, cryotherapy, laser, α-2b interferon and chemotherapeutic agents like 5 fluorouracil. Surgical excision totally eliminates the lesion but the main disadvantage is ≥50% recurrence if used alone. Aims and Objective: To study the effectiveness of Intraoperative Plus Two Post-Operative Injections of Triamcinolone versus Once Intraoperative Triamcinolone in Wedge Excision of Keloid. This was a randomized controlled trial was conducted at the Department of Plastic Surgery at tertiary care health Centre. All the patients diagnosed and want operations or treatment during the complete year 2014 was included into the study those who does not give consent were excluded from the study. There were 70 patients in this study. The study protocol was approved by the institutional ethics committee. Patients fulfilling the inclusion criteria were picked up using consecutive sampling. Patients were randomly allocated into two groups by using computer-generated random number table; Group A having patients who were given single per-operative injection of triamcinolone, and Group B. Result: Most common site affected was Ear pinna followed by Chest, Wrist, Back, Buttock, and Face. Mean size of Keloid Preoperatively was 2.54 ±0.516 and 2.61±0.569 respectively in Group A and Group B but the observed difference was not statistically significant (t=0.539,df=68,p>0.05). But the Recurrence was 10 (28.57%) in Group A was significantly higher than that of the Group B i.e. 3(8.57%) (z= 2.15.p<0.03). Mean size of Keloid Post-operatively was 2.64± 0.495 significantly higher in Group A as compared to Group B i.e. 1.23±0.521 (t=11.60,df=68,p<0.001). Conclusion: It is better to use Two Post-Operative Injections of Triamcinolone in Wedge Excision of Keloid than single use of injection Triamcinolone alone to prevent the not only the recurrence but the size of keloid those in who it was recurred.

Keywords: Keloid, Triamcinolone, Wedge Excision.