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No Significant Wound Healing Effect of Timolol Post-Mohs Micrographic Surgery


No statistically significant differences in physician-reported improvements for scar cosmesis were noticed between the areas treated with topical Timolol and those not.

Clinical Pearls

  • This split-scar prospective study aimed to determine if topical Timolol is effective in promoting wound healing following Mohs Surgery.  

  • 19 adults received topical Timolol to apply to half one’s scar along with standard wound care, while the other half of each wound was treated with standard wound care only.  

  • No statistically significant differences in physician-reported improvements for scar cosmesis were noticed between the areas treated with topical Timolol and those not.


Discussion:

This study by Jeha et al and researchers from Louisiana State University Health Sciences Center aimed to determine whether topical Timolol has efficacy in improving appearances of non-lower extremity, acute surgical wounds after Mohs surgery. The authors cited prior research showing efficacy of topical Timolol in treating chronic, nonhealing ulcers, but limited data on acute wounds.

 

Using a split-scar study design, this prospective study involved nineteen adult patients who underwent Mohs surgery for non-lower extremity, nonmelanoma skin cancer. For each participant, one half of the wound was treated with 0.25% topical Timolol solution along with standard postoperative wound care while the other half was treated with just standard postoperative wound care. Follow-up assessments of each wound were performed at intervals of 1-2 weeks, 4-6 weeks, and 9-12 weeks by 3 independent blinded physicians.

 

Interestingly, following objective evaluation the study found no statistically significant differences in physician-reported improvement for scar cosmesis between the experimental and control areas of each scar. Although, it is important to note that this study is limited by its small sample size and lack of standardization by anatomic site. Additionally, Jeha et al in this study reinforce the hypothesis that Timolol preferentially enhances wound healing in areas prone to poorer wound healing or patients with multiple medical comorbidities. Further studies completed on a larger scale will be necessary to truly determine the utility of topical Timolol in dermatologic surgery.

 

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