Treatment of keloids on anterior chest by implantation of tissue expanders adjacent to or beneath keloid tissues: 17 case report
10.3760/cma.j.issn.0412-4030.2011.02.009
- VernacularTitle:瘢痕旁和瘢痕下扩张器埋植治疗17例胸部瘢痕疙瘩
- Author:
Xiaodong CHEN
;
Lixiong GU
;
Xiaoyan WU
;
Congcong SHEN
;
Hongyu ZHAO
- Publication Type:Journal Article
- Keywords:
Keloid;
Surgical procedures,operative;
Tissues;
Dilatation
- From:
Chinese Journal of Dermatology
2011;44(2):99-102
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe and compare the efficacy and safety of implantation of tissue expanders adjacent to or under keloid tissues for large keloids on anterior chest. Methods Between Mar 2006 and June 2009, a total of 17 patients with large keloid lesions on anterior chest received treatment with 21 tissue expanders,among which 12 were placed under the normal skin adjacent to keloids, and 9 were inserted under the keloid lesions. The scar size varied from 4.5 cm × 3.0 cm to 15.7 cm × 5.5 cm. The capacity was 70 to 400 ml for expanders adjacent to the keloid tissue, 80 to 500 mi for those beneath the keloid tissues. After tissue expansion for 6 to 8 weeks, the expander was removed and keloid lesions were resected followed by the repair of defect with expanded flaps. Further more, the patients received intraoperative local intradermal injection of betamethasone and postoperative superficial electron beam irradiation with divided doses of 7 Gy in 3 consecutive days within 1 week after the surgery. Follow-up varied from 12 to 50 months. Results Twenty expanders, except 1expander pocket which was removed ahead of time due to infection, were implanted successfully during the whole course of treatment. The main complication was expander exposure in 4 patients, including 1 expander adjacent to the keloids and 3 under keloid lesions, which showed no significant influence on secondary operation. Fifteen patients reported relief of symptoms and achieved satisfactory outcomes, while 2 patients, including 1 treated with expanders adjacent to the keloids and 1 with expanders under the keloid tissue, showed great suture tension and experienced delayed stitch removal followed by the recurrence of keloids after the operation.Conclusions The implantation of tissue expanders under the adjacent normal skin or keloid lesions is an ideal treatment option for large keloids on anterior chest. Regional suture tension is a direct contributor to the recurrence of keloid formation after surgical excision.
