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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(03): 251-259
DOI: 10.1055/s-0043-1761599
Original Article

Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years

Autor*innen

  • Neela Bhattacharya 

    1   Department of Plastic Surgery, Anandaloke Multispeciality Hospital, Siliguri, West Bengal, India

  • Kaushik Bhattacharya 

    2   Department of General Surgery, CAPF Composite Hospital, Siliguri, West Bengal, India

  • T.C. Chandran

    3   Institute For Research and Rehabilitation of Hand and Department of Plastic Surgery, Govt. Stanley Medical College, Chennai, Tamil Nadu, India

Funding None.
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Abstract

Background The treatment of keloidal scars with radiotherapy has been practiced for more than a century. Radiotherapy post-surgery has been deemed necessary and effective in preventing recurrence but still, no clear guidelines exist as to the best modality of radiotherapy, the ideal dose, and the time it should be given for keloidal scars. The purpose of this study is to confirm the effectiveness of this treatment and address these issues.

Methods Since 2004, 120 patients presenting with keloidal scars were seen by the author. Out of them, 50 were managed with surgery followed by HDR brachytherapy/electron beam radiotherapy delivering 2000 rads to the scar within 24 hours of surgery. Patients were followed up for at least 18 months to assess the scar status and the recurrence of keloids. Recurrence was defined as the appearance of a nodule or an obvious return of the keloid within 1 year of treatment.

Results Three patients developed a nodule in the scar, which was deemed a recurrence, making an incidence of 6%. There was no major problem after immediate postoperative radiotherapy. Five patients had delayed healing at 2 weeks and a hypertrophic scar was noted in five patients at 4 weeks that settled with conservative measures.

Conclusion Treating the vexing problem of keloids with surgery and immediate postoperative radiotherapy is safe and effective. We recommend that this be adopted as the standard treatment in keloid management.

Keywords

keloid - brachytherapy - radiotherapy - hypertrophic scar - keloid excision

Author's Contributions

N.B. contributed with conceptualization, data curation, formal analysis, methodology, validation, visualization, writing – original draft, writing – review & editing. K.B. contributed with formal analysis, methodology, supervision, validation, visualization, writing–review & editing. T.C.C. contributed with conceptualization, methodology, supervision, validation, and visualization.




Publikationsverlauf

Artikel online veröffentlicht:
21. Februar 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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