BACKGROUND Hypertrophic scars and keloid treatment is a major problem in plastic surgery.While small keloids can be treated with resection followed by radiotherapy,large keloids require treatment with a tissue expande...BACKGROUND Hypertrophic scars and keloid treatment is a major problem in plastic surgery.While small keloids can be treated with resection followed by radiotherapy,large keloids require treatment with a tissue expander.Conventional methods increase the need for auxiliary incisions,causing new scar hyperplasia.AIM To introduce a new method for the treatment of keloids with an expander.METHODS Between 2018 and 2021,we performed surgeries to treat large keloids in nine patients with a two-stage approach.In the first stage,an intrascar incision was made in the keloid,and a customized expander was implanted under the keloid and the surrounding normal skin.A period of 3-6 mo was allowed for skin expansion.In the second stage,after the initial incision healed,a follow-up surgery was performed to remove the expander,resect the keloid,and repair the expanded skin flap.To accomplish this,an incision was made along the scar boundary to avoid making a new surgical incision and creating new scars.Superficial radiotherapy was then performed postoperatively.RESULTS Two patients had anterior chest keloids.After treatment,the anterior chest incision was broken repeatedly and then sutured again after debridement.It healed smoothly without scar hyperplasia.Keloids were successfully removed in 7 patients without recurrence.CONCLUSION This method was performed through a keloid incision and with a custom expander embedded.After full expansion,the keloid was directly resected using a linear suture,which avoids new surgical incisions and scars and can successfully remove large-area keloids.The treatment is effective,providing new insights and strategies for the treatment of similar large-area keloid and hypertrophic scar cases in the future.展开更多
Keloids are a notorious fibroproliferative disorder that may cause cosmetic concerns and life inconvenience.Various methods such as surgery,injection,and laser have been used;however,single treatments are at risk of r...Keloids are a notorious fibroproliferative disorder that may cause cosmetic concerns and life inconvenience.Various methods such as surgery,injection,and laser have been used;however,single treatments are at risk of recurrence;therefore,comprehensive therapy is the better solution.Here,we focused on the management of different medical interventions according to subjective and objective conditions of keloid patients and summarized several clinical comprehensive strategies based on our clinical experience.One original concept of laser combined with radiotherapy was also introduced as a promising method,especially for wide-based pathological scars.展开更多
Presternal butterfly keloid management remains a clinical challenge. This case indicates, with hypo fractionated external beam electron therapy a significant symptomatic and cosmetic benefit may be achieved without an...Presternal butterfly keloid management remains a clinical challenge. This case indicates, with hypo fractionated external beam electron therapy a significant symptomatic and cosmetic benefit may be achieved without any unacceptable acute, chronic or long term toxicity.展开更多
Dermatofibromas are benign soft tissue tumors that predominantly affect the limbs, and more rarely the chest.Keloidal dermatofibroma is a rare subtype with distinct clinicopathological features and an aggressive clini...Dermatofibromas are benign soft tissue tumors that predominantly affect the limbs, and more rarely the chest.Keloidal dermatofibroma is a rare subtype with distinct clinicopathological features and an aggressive clinical course. By researching the evolution of the disease in this study, we aimed to summarize our experience of managing a rare patient who underwent five surgeries for keloidal dermatofibroma that developed sequentially in the upper arm and chest and propose a novel treatment for keloidal dermatofibroma. We concluded that keloidal dermatofibroma involving larger areas, high tension sites, and multiple localizations can be treated using the principles of pathological scar management.展开更多
目的:探讨瘢痕疙瘩下埋植扩张器治疗大面积瘢痕疙瘩的临床疗效。方法:2006年8月—2017年8月,60例瘢痕疙瘩患者共65个部位的瘢痕疙瘩接受瘢痕疙瘩下埋植扩张器治疗。扩张器容量70～600 m L。经50～126 d注水扩张,行瘢痕疙瘩切除或部分切...目的:探讨瘢痕疙瘩下埋植扩张器治疗大面积瘢痕疙瘩的临床疗效。方法:2006年8月—2017年8月,60例瘢痕疙瘩患者共65个部位的瘢痕疙瘩接受瘢痕疙瘩下埋植扩张器治疗。扩张器容量70～600 m L。经50～126 d注水扩张,行瘢痕疙瘩切除或部分切除、扩张器取出和扩张皮瓣转移术,术中即时给予残留瘢痕疙瘩皮损内注射复方倍他米松注射液以及术后浅层电子束照射联合治疗。术后随访12～50个月不等。采用患者与观察者瘢痕评估量表评价疗效。结果:61个部位顺利完成整个治疗过程,4个胸部扩张器因外露提前取出。随访12个月以上,治愈47个部位(占77%);部分复发14个部位(占23%);完全复发0个部位。术前和术后12月的总POSAS评分分别为(59.31±4.94)分和(18.15±1.51)分(P<0.05)。结论:瘢痕疙瘩下埋植扩张器是治疗大面积瘢痕疙瘩较为理想的选择方法之一。展开更多
文摘BACKGROUND Hypertrophic scars and keloid treatment is a major problem in plastic surgery.While small keloids can be treated with resection followed by radiotherapy,large keloids require treatment with a tissue expander.Conventional methods increase the need for auxiliary incisions,causing new scar hyperplasia.AIM To introduce a new method for the treatment of keloids with an expander.METHODS Between 2018 and 2021,we performed surgeries to treat large keloids in nine patients with a two-stage approach.In the first stage,an intrascar incision was made in the keloid,and a customized expander was implanted under the keloid and the surrounding normal skin.A period of 3-6 mo was allowed for skin expansion.In the second stage,after the initial incision healed,a follow-up surgery was performed to remove the expander,resect the keloid,and repair the expanded skin flap.To accomplish this,an incision was made along the scar boundary to avoid making a new surgical incision and creating new scars.Superficial radiotherapy was then performed postoperatively.RESULTS Two patients had anterior chest keloids.After treatment,the anterior chest incision was broken repeatedly and then sutured again after debridement.It healed smoothly without scar hyperplasia.Keloids were successfully removed in 7 patients without recurrence.CONCLUSION This method was performed through a keloid incision and with a custom expander embedded.After full expansion,the keloid was directly resected using a linear suture,which avoids new surgical incisions and scars and can successfully remove large-area keloids.The treatment is effective,providing new insights and strategies for the treatment of similar large-area keloid and hypertrophic scar cases in the future.
基金This study is supported by the National Nature Science Foundation of China(81101432 and 81272036).
文摘Keloids are a notorious fibroproliferative disorder that may cause cosmetic concerns and life inconvenience.Various methods such as surgery,injection,and laser have been used;however,single treatments are at risk of recurrence;therefore,comprehensive therapy is the better solution.Here,we focused on the management of different medical interventions according to subjective and objective conditions of keloid patients and summarized several clinical comprehensive strategies based on our clinical experience.One original concept of laser combined with radiotherapy was also introduced as a promising method,especially for wide-based pathological scars.
文摘Presternal butterfly keloid management remains a clinical challenge. This case indicates, with hypo fractionated external beam electron therapy a significant symptomatic and cosmetic benefit may be achieved without any unacceptable acute, chronic or long term toxicity.
文摘Dermatofibromas are benign soft tissue tumors that predominantly affect the limbs, and more rarely the chest.Keloidal dermatofibroma is a rare subtype with distinct clinicopathological features and an aggressive clinical course. By researching the evolution of the disease in this study, we aimed to summarize our experience of managing a rare patient who underwent five surgeries for keloidal dermatofibroma that developed sequentially in the upper arm and chest and propose a novel treatment for keloidal dermatofibroma. We concluded that keloidal dermatofibroma involving larger areas, high tension sites, and multiple localizations can be treated using the principles of pathological scar management.
文摘目的:探讨瘢痕疙瘩下埋植扩张器治疗大面积瘢痕疙瘩的临床疗效。方法:2006年8月—2017年8月,60例瘢痕疙瘩患者共65个部位的瘢痕疙瘩接受瘢痕疙瘩下埋植扩张器治疗。扩张器容量70～600 m L。经50～126 d注水扩张,行瘢痕疙瘩切除或部分切除、扩张器取出和扩张皮瓣转移术,术中即时给予残留瘢痕疙瘩皮损内注射复方倍他米松注射液以及术后浅层电子束照射联合治疗。术后随访12～50个月不等。采用患者与观察者瘢痕评估量表评价疗效。结果:61个部位顺利完成整个治疗过程,4个胸部扩张器因外露提前取出。随访12个月以上,治愈47个部位(占77%);部分复发14个部位(占23%);完全复发0个部位。术前和术后12月的总POSAS评分分别为(59.31±4.94)分和(18.15±1.51)分(P<0.05)。结论:瘢痕疙瘩下埋植扩张器是治疗大面积瘢痕疙瘩较为理想的选择方法之一。
