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Papers of The 4th Japan Scar Workshop |
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23. Usefulness and problems of flap surgery for keloids
Masayo Aoki, Satoshi Akaishi, Simpei Ono, Itaru Iwakiri, Rei Ogawa, Hiko
Hyakusoku
Department of Plastic and Reconstructive Surgery, Nippon Medical School,
Tokyo, Japan
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OBJECTIVE: For Surgical treatment of keloids, excision and simple suture
with post-operative radiation therapy are considered to be most
effective. However, it is sometimes difficult to do direct suture and we
have to consider skin grafting or flap transfer. We report the effect of
flap surgery after keloid excision with post-operative irradiation.
METHODS: Four patients with keloids were treated with skin flap and
post-operative radiation therapy from 2001 to 2008. We examined their
postoperative course.
RESULTS: The age range was 27-62 (average 43), and the follow-up period
was 14-54 (average 25.5) months. All patients were treated by
post-operative radiation therapy (15Gy/3fractions/3days or
20Gy/4fractions/4days). The results of three patients were excellent or
good (75%), but that of one patient was poor because of the recurrence
of keloids (25%).
DISCUSSION: In flap surgery for keloids, it is important to suppress the
recurrence of keloids from the edge of the flap and donor site. The flap
should be large enough not to cause any tension, while it is necessary
to avoid the tension of the donor site, also to exclude the areas of
predilection. |
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