Abstract
Objective: Keloid offten occurs on chest wall, shoulder and back. Surgical incision and postoperative radiation is an effective method in keloid treatment. Many of the wound in these places can be directly closed after keloids being removed. Recurrence prevention and cosmetic result should all be considered. Operation method especially suture method is one of the key issues which determine the treatment result. Many methods have been developed. However, many of them are designated to prevent recurrence. Cosmetic result is not fully considered. In this article, we reported a new suture method which is with good treatment and cosmetic results in our clinical study. Methods: One hundred and thirty-three patients with chest keloids were treated from 2006 to 2011. Double layer continuous intradermal suture was used in fifty four patients, interrupted epidermal suture was used in forty one patients, and one layer continuous intradermal suture was used in thirty eight patients. All operation sites were treated with radiotherapy on the A¯Â¬Ârst and seventh postoperative day. The follow-up time was from 9 to 26 months. The recurrence rate and cosmetic satisfactory rate was recorded. Data was analyzed with SPSS17.0 software. Recurrence and satisfactory rate were compared with Chi-square test between double layer and interrupted suture, double layer and one layer suture. Results: There were no difference in recurrence rate between double layer and interrupted suture (X2=2.46, P>0.05) or double layer and one layer suture (X2=0.16, P>0.05). Satisfactory cosmetic rates were 72.22%, 29.27% and 39.47% in double layer continuous intradermal suture group, interrupted suture group and one layer continuous intradermal suture group. Difference in satisfactory cosmetic rates is obvious between double layer and interrupted suture (X2=9.30, P<0.01) or double layer and one layer suture (X2=9.05, P<0.01). Conclusion: Double layer continuous intradermal suture can reach good treatment results and more satisfactory cosmetic results in keloid operation.
Highlights
Keloid is benign fibrous growths that usually occur in chest wall, shoulder, back and mandible
There were no difference in recurrence rate between double layer and interrupted suture (X2=2.46, P>0.05) or double layer and one layer suture (X2=0.16, P>0.05)
Difference in satisfactory cosmetic rates is obvious between double layer and interrupted suture (X2=9.30, P
Summary
Keloid is benign fibrous growths that usually occur in chest wall, shoulder, back and mandible. It may be induced by acne, foliculitis, insect bites or other skin injuries such as surgery, lacerations and abrasion [1]. Surgical methods especially wound closure methods are very important in recurrence prevention. Many suture methods were reported in literature Cosmetic result is another issue to be considered in keloid treatment [4]. Cosmetic outcome is as important as recurrence prevention. Based on the principle of recurrence prevention and cosmetic consideration, we used double layer continuous itradermal suture besides basic surgery techniques in keloid operation and compared it with interrupted suture and one layer continuous intradermal suture. Informed consent has been signed by all the patients before operation
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