Use of Topical Timolol Maleate as Re-Epithelialization Agent for Treatment of Recalcitrant Wounds of Varying Etiologies

December 2020 | Volume 19 | Issue 12 | Editorials | 1252 | Copyright © December 2020


Published online December 1, 2020

Brian A. Cahn MS,a,c,* Ramanjot Kaur MD,b,* Penelope A. Hirt MD,c Catherine Tchanque-Fossuo MD,b,d Sara E. Dahle DPM MPH,e Robert S. Kirsner MD PhD,c Roslyn Rivkah Isseroff MD,b,d,* Hadar Lev-Tov MD MASc


*Contributed equally

aAlbert Einstein College of Medicine, Bronx, NY
bDermatology Section, Veterans Affairs Northern California Health Care System, Mather, CA
cDr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL
dDepartment of Dermatology, University of California, Davis, CA
ePodiatry Section, Veterans Affairs, Northern California Health Care System, Mather, CA

In the group that showed no change in wound area, the median treatment duration was 76 days (Table 2). Etiologies are noted in Table 1. Of note, there was difficulty evaluating the ef!cacy of the treatment in the patient with compulsive skin picking due to continued self-excoriations.

In the group with increasing wound area, the median treatment duration was 157 days, the median rate of wound area increase was 0.17 cm2/week, and the median percent increase was 193% (Table 2). The etiologies in this subgroup were all VLUs.

Venous Leg Ulcer
Since the majority of the wounds were VLUs, we conducted a sub-analysis of this cohort. The median healing rate amongst the VLUs was -0.19 cm2/week and the median percent reduction was 100% (Figure 2).

In the healed VLU group, the median treatment duration was 101 days and the median healing rate was -0.19 cm2 per week (Table 2).

In the decreasing wound area group, the median treatment duration was 192 days. median healing rate was -0.24 cm2 per week and the median percent reduction was 62% (Table 2). In the healed VLU group, the median treatment duration was 101 days and the median healing rate was -0.19 cm2 per week (Table 2).

None of the VLU wounds went unchanged after treatment. However, the 2 wounds that worsened were VLUs.

In both the healed and decreasing wound area groups, the healing rate was fastest amongst the wounds that received continuous timolol application or every day application, followed by every other day application and twice a day application (Table 3). Additionally, the highest percent reduction in wound size was in continuous application followed by every day application.