Dermal Matrix-Assisted Reconstruction After Keloid Excision: Long-Term Outcomes of a Combined Therapeutic Protocol

Area of Science:

• Dermatology
• Regenerative Medicine
• Surgical Oncology

Background:

• Extensive keloids pose significant therapeutic challenges due to high recurrence rates (40-100%) after surgical excision alone.
• These lesions cause functional, aesthetic, and psychological distress.
• A multimodal approach using dermal regeneration matrix and intralesional corticosteroids is a promising alternative.

Purpose of the Study:

• To evaluate the effectiveness of a combined treatment protocol for extensive keloids.
• To assess the impact of dermal regeneration matrix and corticosteroid injections on keloid recurrence.
• To determine the role of skin grafting in conjunction with this protocol.

Main Methods:

• Retrospective study of 66 extensive keloids treated from 2015-2023.
• Surgical excision followed by dermal matrix application and secondary intention healing or skin grafting.
• Monthly postoperative intralesional triamcinolone acetonide injections.

Main Results:

• A 65% success rate was achieved in treating extensive keloids with the combined approach.
• The addition of skin grafting significantly reduced keloid recurrence (P < 0.01).
• Donor site keloid formation occurred in 20% of cases.

Conclusions:

• The combined therapy of dermal regeneration matrix and intralesional corticosteroids is effective for extensive keloids.
• Skin grafting reduces recurrence risk but increases the risk of donor site keloid formation.
• Further randomized prospective studies are needed to optimize patient selection and treatment strategies.