title: The treatment of keloids with pneumatic technology: a pilot study.
abstract: BACKGROUND
  Keloid scars derive from abnormal fibrous wound healing when the mechanisms controlling tissue repair and regeneration malfunction. Previous studies have reported a reduction in hyaluronic acid among fibroblasts cultured from keloid tissue compared with the levels in normal skin. Here, we evaluated the efficacy and safety of subdermal minimal surgery using hyaluronic acid as a novel treatment in keloid scars.
  
  
  OBJECTIVE
  To evaluate the clinical efficacy and safety of subdermal minimal surgery technology in the treatment of keloids.
  
  
  METHODS
  Ten Korean patients (Fitzpatrick skin type II-IV) with keloids on the upper arms were enrolled in this study. All patients underwent three sessions of subdermal minimal surgery at three-week intervals. Scar assessments were performed at baseline, before each treatment session, and three months after the final treatment, with three different assessment methods. Specifically, in addition to the Vancouver Scar Scale (VSS), two independent physicians performed global assessment evaluations regarding the final cosmetic results. As a final form of assessment, participant satisfaction was assessed using a four-point scale.
  
  
  RESULTS
  All volunteers completed three treatment sessions, and nine of 10 patients were satisfied with the procedure. The average VSS score decreased three months after the final treatment, and global assessment showed clinical improvement of the scars. No adverse events occurred, except transient spot bleeding at entry points and slight post-procedure edema, which resolved within 48 hours.
  
  
  CONCLUSIONS
  Subdermal minimal surgery technology may help to improve keloids on the upper arm without noticeable adverse effects.
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hyun Kyu
authors.initials: HK
authors.lastname: Kim
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Park
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
authors.forename: Myeung Nam
authors.initials: MN
authors.lastname: Kim
authors.forename: Chan Woong
authors.initials: CW
authors.lastname: Kim
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D007627:Keloid / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D010865:Pilot Projects; D056910:Republic of Korea; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D055815:Young Adult
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid