Papers of The 8th Japan Scar Workshop

6. Treatment of keloids and hypertrophic scars

Department of Plastic and Reconstructive Surgery, Takarazuka City Hospital, Hyogo, Japan
Masato Kurokawa

Surgical treatment is my first choice for hypertrophic scars. Although surgery is based on full excision of hypertrophic scars and contracture release, when scars are wide, partial excision may be performed. However, when contractures are released, hypertrophic scars decrease gradually in many cases.
The basic treatment I apply is a combination of conservative treatments, such as steroid, silicone, laser, tranirlast, and pressure therapy for keloids. However, if there is extensive scarring after the keloids have disappeared with these treatments, partial excision of the scars may be performed. In the cases of scar keloids, contracture is a major factor; I sometimes select surgical treatment for the purpose of reliable contracture release. In such a case, a combination of conservative treatments is applied from the early postoperative period, in order to prevent keloid recurrence. Although postoperative radiation therapy is not performed at our institution, radition therapy should be considered when the tendency for recurrence is strong.
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