Large chest keloids treatment with expanded parasternal intercostal perforator flap

Area of Science:

• Plastic Surgery
• Dermatology
• Wound Healing

Background:

• Large chest keloids pose significant challenges for surgical excision and reconstruction.
• Convergent keloid lesions can complicate treatment approaches.

Purpose of the Study:

• To evaluate the efficacy of the expanded parasternal intercostal perforator flap (EPIPF) surgical technique for managing large chest keloids.
• To assess patient satisfaction and complication rates associated with EPIPF for chest keloid treatment.

Main Methods:

• A case series involving 15 patients with large chest keloids treated between August 2017 and December 2019.
• The EPIPF technique involved two phases: skin expander implantation and gradual expansion, followed by keloid excision and flap reconstruction.
• Post-operative follow-up included analysis of complications, recurrence, and patient-reported aesthetic satisfaction.

Main Results:

• One patient experienced minor wound healing complications.
• Eleven patients achieved successful outcomes with no scar hypertrophy or recurrence.
• Four patients had partial success with minor scar hypertrophy; all patients reported acceptable to good aesthetic results.

Conclusions:

• The expanded parasternal intercostal perforator flap (EPIPF) is an effective surgical option for large chest keloids.
• This method ensures adequate skin flap coverage and stable vascularity for successful wound resurfacing.
• EPIPF surgery leads to high patient satisfaction rates in managing challenging chest keloid cases.