Papers of The 8th Japan Scar Workshop

18. Surgical treatment for keloids and hypertrophic scars - pros and cons of surgery -

Yasuyoshi Tosa, Tomoaki Kuroki, Taro Kusano, Shinya Yoshimoto
Department of Plastic and Reconstructive Surgery, Showa University School of Medicine, Tokyo, Japan

Keloids and hypertrophic scars are disorders caused by trauma, surgery or burns in which the scars develop into deformities over a long time. In addition to the objective symptom of deformity, they are accompanied by subjective symptoms of pain and itching, so they are very distressing to the patient. Plastic surgeons have been prone to taking surgical resection as the first choice, but seeing the cases of recurrence and worsening after surgery, it seems that rather than surgery, , the postoperative course depends more on keloid diathesis and the site of onset, and we should consider an indication that takes these factors more strongly into account. Recently, combination with electron beam therapy has had positive effects and contributed to the postoperative course. However, among patients with strong keloid diathesis, even after a favorable course for 2-3 years, we have experienced cases of subsequent recurrence in long-term follow-up. In presenting our current treatment policy, we show the importance of considering keloid diatheses and site of onset when considering the pros and cons of surgical treatment.
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