A parasternal intercostal perforator flap for esthetic reconstruction after complete chest keloid resection: A retrospective observational cohort study.

Abstract

To report on the outcome of 35 patients with chest keloids who were treated with intercostal perforator flap surgery plus local radiotherapy at our hospital. We retrospectively analyzed the data of patients with chest keloid who under surgical resection at the Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China between March 2014 and July 2017. We retrieved patient demographic data, donor site position, the perforator pedicle, flap size, angle of flap rotation, complications, and recurrences from the medical records. All patients underwent perforator flap surgery for complete keloid resection followed by radiation at postoperative day 1 and 8 for a total dose 16-18Gy. Thirty-five patients were included in the retrospective analysis. Their mean age was 45.3years (range 24-67years). The mean keloid area was 5-7cm×6-10cm. Surgeries were successful in all cases. There were no perioperative complications. Good outcome with no apparent scar growth was achieved in 88.6% of the cases, and 11.4% of the cases achieved satisfactory outcome with partial scar growth in the incision, but no keloid was observed. Twenty-four months after surgery, none of the resected keloids recurred and none of the donor sites developed new keloids. Intercostal perforator flap surgery is an effective and safe approach for repair of wound formed as a result of excision of relatively large chest keloids which cannot be directly appositioned.