Outcome of Large Keloids with Precut Technique

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Author(s): 1,Ayesha Usman 2,Ali Rafique Mirza 3,Tauqeer Nazim 4, Ayeza Latif 5,Sarfaraz Ahmed

Received: 18/04/2022 | Published: 05/09/2022 | Pages: 55-59 |

Keloids are benign skin lesions that are often a cause of functional and cosmetic concern for the patient. The Objective of this study was to evaluate the aesthetic satisfaction and outcome of precut technique in patients with keloids requiring skin graft. Methodology: This was an observational study done at the Department of Plastic Surgery, Shaikh Zayed Hospital, Lahore from June 2020 to May, 2021. An incision was made down to the subcutaneous layer around the edge of the keloid (precut), and radiotherapy (pre graft) was applied on the following day. Next day, the keloid was excised and wound closed with an intermediate thickness skin graft. Second fraction of radiotherapy was given in 2 weeks when the graft take was satisfactory. Patients were followed up, and at 12 weeks the scar was evaluated by doctor. Aesthetic satisfaction was determined by the patient using verbal rating scale VRS questionnaire. The data was evaluated using chi- square- test. Results: Sixty seven(67) patients with keloids greater than 4cm2 were treated by using the precut, pre graft radiotherapy technique. Sixty four patients (64) out of 67 patients (95%) had cure at the scar site with incision margins soft, pale and flat. Three patients (5%) had graft contraction with firm, pale and protuberant incision margins. Also, 64 (95%) patients were satisfied with the aesthetic results and rated the scar site as good outcome. Only 3(5%) patients were dissatisfied with the results and rated scar site as poor outcome. Conclusion: Keloid edge precut, pre-graft radiotherapy method is effective treatment method for patients with large keloids that require excision and skin graft.

Keywords | Keloids, Skin Graft, Precut technique, Pre graft Radiation, Hypertrophic Scars.