S-shaped Wound Closure Technique for Dumbbell-shaped Keloids
Seiji Komatsu1, Shougo Azumi1, Yuko Hayashi1
1Department of Plastic and Reconstructive Surgery, Okayama Saiseikai General Hospital, Okayama, Japan; Department of Radiology, Okayama Saiseikai General Hospital, Okayama, Japan; and Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Plastic and Reconstructive Surgery. Global Open
|May 2, 2017
Summary
This study introduces an S-shaped wound closure technique for dumbbell-shaped keloids, avoiding extra incisions and improving scar appearance. The method demonstrated significant scar improvement and low recurrence rates in keloid treatment.
Area of Science:
- Plastic Surgery
- Dermatology
- Wound Healing
Background:
- Traditional keloid excision methods like dog-ear collection, Z-plasty, and W-plasty often necessitate additional incisions or normal skin excision.
- These conventional techniques can lead to increased scarring and may not fully address the complex geometry of dumbbell-shaped keloids.
Purpose of the Study:
- To evaluate the efficacy and aesthetic outcomes of a novel S-shaped wound closure technique for treating dumbbell-shaped keloids.
- To assess the technique's ability to minimize additional scarring and prevent keloid recurrence.
Main Methods:
- The S-shaped closure involved extralesional excision of keloid lesions above the deep fascia.
- Wound edges were manipulated along the major axis to create an S-shape, closed with deep fascial, subcutaneous, and superficial sutures.
- Postoperative management included external beam radiation therapy, silicone-gel sheeting, and corticosteroid tape for recurrence management.
Main Results:
- Eight keloid lesions were treated using the S-shaped technique.
- A significant improvement in scar quality was observed, with mean Manchester Scar Scale scores decreasing from 15.8 to 7.2.
- Two cases experienced temporary erythema and scar elevation, which resolved with corticosteroid tape; no other recurrences or complications were noted.
Conclusions:
- The S-shaped wound closure technique offers a valuable alternative for dumbbell-shaped keloid treatment by avoiding extra incisions and minimizing scarring.
- This method yields good aesthetic results, reduces scar tension, and effectively prevents keloid recurrence.
- While having specific applications, the S-shaped technique represents a useful advancement in keloid management.
