Abstract：
BACKGROUND: Surgical excision combined with radiotherapy is considered an effective treatment for keloids, while the efficacy and safety of this regimen for huge keloids in patients who need reconstruction after excision is still unclear. Therefore, this study aimed to evaluate the efficacy and safety of surgical excision and reconstruction combined with radiotherapy for huge keloids in a single center with 13 years of experience.
METHODS: All consecutive patients with huge keloids who underwent surgical excision and reconstruction combined with radiotherapy were identified. Demographic information, prior interventions for keloids, parameters and complications, and recurrence rates were documented.
RESULTS: Twenty-one patients (10 males; mean age, 43.19 ± 18.15 years) were included, 14 patients reconstructed with z-plasties, 5 with skin grafts, and 2 with skin flaps. During a mean follow-up of 75 months, one patient developed local necrosis without the need for revision surgery and two patients developed temporary hyperpigmentation. Two patients with the z-plasties suffered partial keloids recurrence, which was healed with corticosteroid injection. No wound infection, hematoma, telangiectasia, or new keloids at donor sites were observed. The overall appearance of reconstructed defects was aesthetically acceptable.
CONCLUSIONS: Surgical excision and reconstruction combined with radiotherapy may be safe and effective for huge keloids.
METHODS: All consecutive patients with huge keloids who underwent surgical excision and reconstruction combined with radiotherapy were identified. Demographic information, prior interventions for keloids, parameters and complications, and recurrence rates were documented.
RESULTS: Twenty-one patients (10 males; mean age, 43.19 ± 18.15 years) were included, 14 patients reconstructed with z-plasties, 5 with skin grafts, and 2 with skin flaps. During a mean follow-up of 75 months, one patient developed local necrosis without the need for revision surgery and two patients developed temporary hyperpigmentation. Two patients with the z-plasties suffered partial keloids recurrence, which was healed with corticosteroid injection. No wound infection, hematoma, telangiectasia, or new keloids at donor sites were observed. The overall appearance of reconstructed defects was aesthetically acceptable.
CONCLUSIONS: Surgical excision and reconstruction combined with radiotherapy may be safe and effective for huge keloids.
摘要：
背景：手术切除联合放疗被认为是治疗瘢痕疙瘩的有效方法，虽然该方案对切除后需要重建的巨大瘢痕疙瘩患者的疗效和安全性尚不清楚。因此,本研究旨在评估单中心手术切除重建联合放疗治疗巨大瘢痕疙瘩的疗效和安全性。
方法：所有连续的巨大瘢痕疙瘩患者均接受手术切除和重建联合放疗。人口统计信息,先前对瘢痕疙瘩的干预，参数和并发症，并记录复发率。
结果：21名患者（10名男性；平均年龄，包括43.19±18.15年)，14例患者用z-plays重建，5与皮肤移植，和2个皮瓣。在平均75个月的随访中，1例患者出现局部坏死,无需进行翻修手术,2例患者出现暂时性色素沉着.两名患有z型整形手术的患者部分瘢痕疙瘩复发，用皮质类固醇注射治愈。没有伤口感染,血肿,毛细血管扩张症,或在供体部位观察到新的瘢痕疙瘩。重建缺陷的整体外观在美学上是可以接受的。
结论：手术切除重建联合放疗治疗巨大瘢痕疙瘩安全有效。
方法：所有连续的巨大瘢痕疙瘩患者均接受手术切除和重建联合放疗。人口统计信息,先前对瘢痕疙瘩的干预，参数和并发症，并记录复发率。
结果：21名患者（10名男性；平均年龄，包括43.19±18.15年)，14例患者用z-plays重建，5与皮肤移植，和2个皮瓣。在平均75个月的随访中，1例患者出现局部坏死,无需进行翻修手术,2例患者出现暂时性色素沉着.两名患有z型整形手术的患者部分瘢痕疙瘩复发，用皮质类固醇注射治愈。没有伤口感染,血肿,毛细血管扩张症,或在供体部位观察到新的瘢痕疙瘩。重建缺陷的整体外观在美学上是可以接受的。
结论：手术切除重建联合放疗治疗巨大瘢痕疙瘩安全有效。
