Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years
Background The treatment of keloidal scars with radiotherapy has been practiced for more than a century. Radiotherapy post-surgery has been deemed necessary and effective in preventing recurrence but still, no clear guidelines exist as to the best modality of radiotherapy, the ideal dose, and the ti...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2023-06-01
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| Series: | Indian Journal of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1761599 |
| _version_ | 1797783624320286720 |
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| author | Neela Bhattacharya Kaushik Bhattacharya T.C. Chandran |
| author_facet | Neela Bhattacharya Kaushik Bhattacharya T.C. Chandran |
| author_sort | Neela Bhattacharya |
| collection | DOAJ |
| description | Background The treatment of keloidal scars with radiotherapy has been practiced for more than a century. Radiotherapy post-surgery has been deemed necessary and effective in preventing recurrence but still, no clear guidelines exist as to the best modality of radiotherapy, the ideal dose, and the time it should be given for keloidal scars. The purpose of this study is to confirm the effectiveness of this treatment and address these issues.
Methods Since 2004, 120 patients presenting with keloidal scars were seen by the author. Out of them, 50 were managed with surgery followed by HDR brachytherapy/electron beam radiotherapy delivering 2000 rads to the scar within 24 hours of surgery. Patients were followed up for at least 18 months to assess the scar status and the recurrence of keloids. Recurrence was defined as the appearance of a nodule or an obvious return of the keloid within 1 year of treatment.
Results Three patients developed a nodule in the scar, which was deemed a recurrence, making an incidence of 6%. There was no major problem after immediate postoperative radiotherapy. Five patients had delayed healing at 2 weeks and a hypertrophic scar was noted in five patients at 4 weeks that settled with conservative measures.
Conclusion Treating the vexing problem of keloids with surgery and immediate postoperative radiotherapy is safe and effective. We recommend that this be adopted as the standard treatment in keloid management. |
| first_indexed | 2024-03-13T00:28:32Z |
| format | Article |
| id | doaj.art-ee2e603cf68640f3ab349245aaa00396 |
| institution | Directory Open Access Journal |
| issn | 0970-0358 1998-376X |
| language | English |
| last_indexed | 2024-03-13T00:28:32Z |
| publishDate | 2023-06-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj.art-ee2e603cf68640f3ab349245aaa003962023-07-11T00:17:51ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2023-06-01560325125910.1055/s-0043-1761599Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 YearsNeela Bhattacharya0Kaushik Bhattacharya1T.C. Chandran2Department of Plastic Surgery, Anandaloke Multispeciality Hospital, Siliguri, West Bengal, IndiaDepartment of General Surgery, CAPF Composite Hospital, Siliguri, West Bengal, IndiaInstitute For Research and Rehabilitation of Hand and Department of Plastic Surgery, Govt. Stanley Medical College, Chennai, Tamil Nadu, IndiaBackground The treatment of keloidal scars with radiotherapy has been practiced for more than a century. Radiotherapy post-surgery has been deemed necessary and effective in preventing recurrence but still, no clear guidelines exist as to the best modality of radiotherapy, the ideal dose, and the time it should be given for keloidal scars. The purpose of this study is to confirm the effectiveness of this treatment and address these issues. Methods Since 2004, 120 patients presenting with keloidal scars were seen by the author. Out of them, 50 were managed with surgery followed by HDR brachytherapy/electron beam radiotherapy delivering 2000 rads to the scar within 24 hours of surgery. Patients were followed up for at least 18 months to assess the scar status and the recurrence of keloids. Recurrence was defined as the appearance of a nodule or an obvious return of the keloid within 1 year of treatment. Results Three patients developed a nodule in the scar, which was deemed a recurrence, making an incidence of 6%. There was no major problem after immediate postoperative radiotherapy. Five patients had delayed healing at 2 weeks and a hypertrophic scar was noted in five patients at 4 weeks that settled with conservative measures. Conclusion Treating the vexing problem of keloids with surgery and immediate postoperative radiotherapy is safe and effective. We recommend that this be adopted as the standard treatment in keloid management.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1761599keloidbrachytherapyradiotherapyhypertrophic scarkeloid excision |
| spellingShingle | Neela Bhattacharya Kaushik Bhattacharya T.C. Chandran Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years Indian Journal of Plastic Surgery keloid brachytherapy radiotherapy hypertrophic scar keloid excision |
| title | Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years |
| title_full | Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years |
| title_fullStr | Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years |
| title_full_unstemmed | Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years |
| title_short | Treatment of Keloids with Surgery and Immediate Postoperative Radiotherapy: Knowledge Gained Over 17 Years |
| title_sort | treatment of keloids with surgery and immediate postoperative radiotherapy knowledge gained over 17 years |
| topic | keloid brachytherapy radiotherapy hypertrophic scar keloid excision |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1761599 |
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