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[Analysis of curative result for keloid with integrated methods]
Zheng-jun Cui1, Ying Cen, Xiao-xue Liu
1Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China 610041.
Summary
Surgical removal of keloids followed by beta radiation therapy is effective. A longer course of radiation (10 fractions) yielded better results than a shorter course (5 fractions), and silicone gel sheeting improved skin quality.
Area of Science:
- Dermatology and Plastic Surgery
- Oncology and Radiation Therapy
Context:
- Keloids are benign fibroproliferative tumors resulting from abnormal wound healing.
- Current treatment modalities for keloids include surgical excision, radiation therapy, and silicone gel sheeting, often used in combination.
Purpose:
- To evaluate the efficacy of combined surgical excision, postoperative beta radiation, and silicone gel sheeting for keloid treatment.
- To compare different fractionation schedules of beta radiation therapy.
- To assess the adjunctive benefit of silicone gel sheeting in keloid management.
Summary:
- A study involving 598 keloid patients compared surgical excision with direct suture versus skin grafting, followed by varying beta radiation schedules (5 or 10 fractions) and silicone gel sheeting.
- The 10-fraction radiation group (Group B) showed significantly higher overall efficacy (95.8%) compared to the 5-fraction group (Group A, 91.3%).
- Skin grafting yielded poor results, while silicone gel sheeting improved skin texture and color but did not significantly impact overall efficacy.
Impact:
- Direct wound suturing is preferred over skin grafting for keloid excision when feasible.
- A 10-fraction beta radiation schedule is superior to a 5-fraction schedule for postoperative keloid management.
- Silicone gel sheeting is recommended as an adjunct to improve cosmetic outcomes post-treatment.