[Analysis of curative result for keloid with integrated methods]

To study the curative effects of keloid by operation combined with postoperative beta radiation and silicone gel sheeting.

From 1996 to 2002, 598 patients with keloid (243 males, 355 females, aging 15-55 years with an average of 28.6 years) were treated by integrated therapy. Their disease courses were from 6 months to 6 years. The keloid area ranged from 1.0 cm x 1.5 cm-8.0 cm x 15 cm. First, keloid was removed by operation, and then the wounds were sutured directly (group suture) or covered with skin graft (group graft). In group suture, the operational sites were managed by beta ray radiotherapy 24-48 hours after operation. The total doses of radiation were 12-15 Gy, 5 times 1 week (group suture A) and 10 times 2 weeks (group suture B). Radiotherapy was not taken until stitches were taken out in group graft, and then the same methods were adopted as group suture B. After radiotherapy, silicone gel sheeting was used in 325 cases for 3-6 months.

All patients were followed up for 12-18 months. (1) The overall efficacy was 91.3% in group suture A (n = 196), and 95.8% in group suture B (n = 383), respectively. There was significant difference between the two groups (P < 0.01). (2) Radiotherapy was of no effect in 6 cases of group graft (n = 19). (3) Silicone gel sheeting had effectiveness in 185 cases. Silicone gel sheeting had no obvious effect on the overall efficacy, but it could improve the quality of texture and color of skin.

By use of integrated methods to treat keloid, if the wound can be sutured directly, skin grafting should not be adopted. The results in group suture B are better than those in group suture A; silicone gel sheeting should be used as possible.