Treatment of keloids by combined surgical excision and immediate postoperative X-ray therapy

Sixty-eight histopathologically confirmed keloids were excised in 40 patients from 1970 to 1979. Surgery involved intrakeloidal excision with wound closure by direct, multilayered advancement repair or split-thickness skin grafting. All patients received x-ray therapy totaling 1,500 rads delivered in 3 equal doses, the first within several hours after surgery and the rest at two- to three-day intervals. There was a minimum of one year's follow-up in all cases, with a mean follow-up time of approximately twenty-four months. Recurrence rates of 21% per lesion and 28% per patient were obtained for the series. Earlobe keloids had recurrence rates similar to those noted for the series of a whole. Seventy-five percent of recurrences were evident within twelve months following treatment. Intrakeloidal excision combined with immediate postoperative x-ray therapy is effective in treating keloids.