Papers of The 9th Japan Scar Workshop

5. Title: Surgical treatment combined with post-operative electron beam irradiation for large keloids that cannot be closed directly

Fumiaki Shimizu MD, PhD, Miwako Oatari MD, and Miyuki Uehara MD
Department of Plastic Surgery, Oita University Hospital

Although there are many reports regarding the treatment of keloids, surgical excision followed by post-operative irradiation is now recognized as one of the most effective therapies for keloids. During the operation, it is ideal to excise the entire affected region and then to close the defect directly with a low amount of tension. In this report, we present five cases in which keloids were too large to be closed directly. In all patients, surgical excision followed by post-operative radiotherapy was performed. In two cases, the defect was reconstructed with a propeller flap during the operation. In one case, serial excision was performed followed by radiotherapy after the final excision. In another two cases, total excision was not performed. In these two cases, only the reddish area of the keloid was excised and radiotherapy was performed. Using these procedures, all keloids could be controlled.
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