Papers of The 8th Japan Scar Workshop

9. Indication of Surgery for Keloids and Hypertrophic Scars

Rei Ogawa, Satoshi Akaishi, Hiko Hyakusoku
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan

It has been widely believed that keloids should not be treated by surgery because of a high incidence of recurrence. However, mechanisms of keloid development have been studied extensively in recent years. Important factors that promote keloid and hypertrophic scar development include mechanical forces on the wound, and persistent local inflammation. Thus, mechanical force reduction and direct inhibition of inflammation will be the main treatment strategy. Keloids have thus been treated successfully by surgery and post-operative adjuvant therapies such as radiation therapy, and intra- and post- operative tension reduction methods such as taping fixation. In this paper, four important factors were discussed when considering the indication of surgery for keloids and hypertrophic scars; age and lifestyle of patients, configuration/function problems, and strength of inflammation.
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