Keloid Management: A Retrospective Case Review on a New Approach Using Surgical Excision, Platelet-Rich Plasma, and In-office Superficial Photon X-ray Radiation Therapy.
OBJECTIVE
The objective of this retrospective study was to evaluate the efficacy of the authors' combination therapy protocol for keloid treatment.


METHODS
Retrospective.


METHODS
Plastic surgery office-based outpatient setting in New York City.


METHODS
Forty patients with 44 keloid scars requiring surgical excision.


METHODS
Keloid scars were treated using surgical excision, platelet-rich plasma, and postoperative in-office superficial photon X-ray radiation therapy. Intralesional triamcinolone injections were administered once to 4 patients with poor results on scar scale assessment. Patient follow-up visits ranged from 3 to 11 months to assess for evidence of recurrence and adverse effects.


METHODS
For the purpose of this study, recurrence was defined as any sign of extraordinary erythema, induration, and hypertrophy beyond the site of excision.


RESULTS
In the 16 keloids treated with 2 fractions, there was no evidence of recurrence. One of 25 keloids treated with 3 fractions demonstrated evidence of recurrence. One of 3 keloids treated with a single fraction displayed signs of recurrence. Postirradiation hyperpigmentation was noted in all patients.


CONCLUSIONS
Surgical excision combined with platelet-rich plasma and postoperative in-office superficial radiation therapy achieved a 95.5% nonrecurrence rate at 1- to 3-month follow-up. This protocol appears to be a safe and viable option in the management of keloids and merits further randomized controlled study of its comparative efficacy.
Michael E. Jones, MD, is founder/medical director; Cherrell Hardy, BSN, RN, is nurse manager; and Julie Ridgway, BSN, RN, is a registered nurse, all at Lexington Plastic Surgeons, New York, New York.
Michael E
ME
Jones
Cherrell
C
Hardy
Julie
J
Ridgway
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007627:Keloid / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D053657:Platelet-Rich Plasma; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013518:Surgery, Plastic / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult