title: Keloid banding using suture ligature: a novel technique and review of literature.
abstract: BACKGROUND
  Successful wound healing represents the coordinated response of cellular, cytokine, and growth factor mechanisms involved in tissue recovery. Disruptions in transforming growth factor-beta signaling, senescence/apoptosis, keratinocyte-fibroblast interactions, and other regulatory cascades can lead to the production of hypertrophic scar or keloid tissue formation. Current clinical investigations support surgical excision, meticulous closure, postoperative steroid injections, and postprocedural pressure dressings in the treatment of keloid tissue formation. Unfortunately, a universal approach in keloid therapy has yet to be identified. Here we offer a novel banding technique using suture ligature for the removal of these tissues.
  
  
  METHODS
  Using a suture ligature, keloid tissues were banded along their base for a 5-week period. Tissue evaluation and additional suture banding was performed on a weekly basis until complete mummification and spontaneous removal of ligated tissues. No additional pressure dressings were placed after tissue removal as treated sites had essentially undergone pressure therapy from the banding treatment.
  
  
  RESULTS
  Keloid tissues from multiple sites of the head and neck were effectively removed without complication using the suture banding technique. During a follow-up period of 12 months, no evidence of keloid tissue recurrence was observed.
  
  
  CONCLUSIONS
  Keloid tissue formation remains a formidable challenge for the patient and physician alike. The application of a simple tissue banding technique holds promise in the direct and preventative treatment of keloid tissue formation whereas the end results merit further clinical and laboratory investigation.
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California 92868, USA.
authors.forename: Dhavan A
authors.initials: DA
authors.lastname: Parikh
authors.forename: James M
authors.initials: JM
authors.lastname: Ridgway
authors.forename: Norman N
authors.initials: NN
authors.lastname: Ge
mesh_terms: D006259:Craniocerebral Trauma / Q000150:complications* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007627:Keloid / Q000473:pathology / Q000601:surgery*; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications* / Q000473:pathology; D013536:Suture Techniques / Q000295:instrumentation*; D015599:Trauma Severity Indices