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Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients
Therapies for upper arm keloids include surgical excision followed by postoperative radiotherapy, silicone tape stabilization, and steroid plaster. However, a universally accepted therapeutic strategy for upper-arm keloids is lacking. METHODS: All consecutive patients with single upper-arm keloids w...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908330/ https://www.ncbi.nlm.nih.gov/pubmed/31942294 http://dx.doi.org/10.1097/GOX.0000000000002496 |
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author | Dohi, Teruyuki Kuribayashi, Shigehiko Tosa, Mamiko Aoki, Masayo Akaishi, Satoshi Ogawa, Rei |
author_facet | Dohi, Teruyuki Kuribayashi, Shigehiko Tosa, Mamiko Aoki, Masayo Akaishi, Satoshi Ogawa, Rei |
author_sort | Dohi, Teruyuki |
collection | PubMed |
description | Therapies for upper arm keloids include surgical excision followed by postoperative radiotherapy, silicone tape stabilization, and steroid plaster. However, a universally accepted therapeutic strategy for upper-arm keloids is lacking. METHODS: All consecutive patients with single upper-arm keloids who underwent keloid excision followed by tension-reducing suturing, multiple z-plasties, and postoperative radiotherapy in 2013–2016 in the keloid/scar specialist clinic at the Department of Plastic, Reconstructive and Aesthetic Surgery of Nippon Medical School, were included in this case series study. Only keloids that arose from the small injury produced during Bacillus Calmette–Guérin vaccination were selected. The postsurgical radiotherapy regimen was 18 Gy administered in 3 fractions over 3 days. Radiotherapy was followed by tension-reducing wound self-management with silicone tape and, if needed, steroid plaster. The primary study objective was keloid recurrence during the 24-month follow-up period. Recurrence was defined as the growth of stiff red lesions in even small areas of the scar that was refractory to at least 2 months of steroid plaster therapy. RESULTS: In total, 38 patients with 38 lesions were enrolled. Two lesions (5.3%) recurred. Both recurrences were successfully treated by concomitant steroid plaster and steroid injection. The recurrence patients were significantly more likely than the nonrecurrence patients to have multiple keloids. The 2 groups did not differ in terms of original keloid size. CONCLUSIONS: Upper-arm keloids can be successfully treated by customized plans that involve appropriate surgical modalities (including multiple z-plasties), postoperative radiotherapy (18 Gy/3 fractions/3 d), and postoperative wound/scar self-management with silicone tape and steroid plaster. |
format | Online Article Text |
id | pubmed-6908330 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-69083302020-01-15 Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients Dohi, Teruyuki Kuribayashi, Shigehiko Tosa, Mamiko Aoki, Masayo Akaishi, Satoshi Ogawa, Rei Plast Reconstr Surg Glob Open Original Article Therapies for upper arm keloids include surgical excision followed by postoperative radiotherapy, silicone tape stabilization, and steroid plaster. However, a universally accepted therapeutic strategy for upper-arm keloids is lacking. METHODS: All consecutive patients with single upper-arm keloids who underwent keloid excision followed by tension-reducing suturing, multiple z-plasties, and postoperative radiotherapy in 2013–2016 in the keloid/scar specialist clinic at the Department of Plastic, Reconstructive and Aesthetic Surgery of Nippon Medical School, were included in this case series study. Only keloids that arose from the small injury produced during Bacillus Calmette–Guérin vaccination were selected. The postsurgical radiotherapy regimen was 18 Gy administered in 3 fractions over 3 days. Radiotherapy was followed by tension-reducing wound self-management with silicone tape and, if needed, steroid plaster. The primary study objective was keloid recurrence during the 24-month follow-up period. Recurrence was defined as the growth of stiff red lesions in even small areas of the scar that was refractory to at least 2 months of steroid plaster therapy. RESULTS: In total, 38 patients with 38 lesions were enrolled. Two lesions (5.3%) recurred. Both recurrences were successfully treated by concomitant steroid plaster and steroid injection. The recurrence patients were significantly more likely than the nonrecurrence patients to have multiple keloids. The 2 groups did not differ in terms of original keloid size. CONCLUSIONS: Upper-arm keloids can be successfully treated by customized plans that involve appropriate surgical modalities (including multiple z-plasties), postoperative radiotherapy (18 Gy/3 fractions/3 d), and postoperative wound/scar self-management with silicone tape and steroid plaster. Wolters Kluwer Health 2019-11-27 /pmc/articles/PMC6908330/ /pubmed/31942294 http://dx.doi.org/10.1097/GOX.0000000000002496 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Article Dohi, Teruyuki Kuribayashi, Shigehiko Tosa, Mamiko Aoki, Masayo Akaishi, Satoshi Ogawa, Rei Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients |
title | Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients |
title_full | Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients |
title_fullStr | Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients |
title_full_unstemmed | Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients |
title_short | Z-plasty and Postoperative Radiotherapy for Upper-arm Keloids: An Analysis of 38 Patients |
title_sort | z-plasty and postoperative radiotherapy for upper-arm keloids: an analysis of 38 patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908330/ https://www.ncbi.nlm.nih.gov/pubmed/31942294 http://dx.doi.org/10.1097/GOX.0000000000002496 |
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