The Use of Integra Artificial Dermis for Keloid Scars

Abstract

Introduction: Keloid scars are notoriously difficult lesions to treat, and at the present time, there is no universally effective therapy. Numerous theories have been put forth regarding keloid formation, but the pathophysiologic mechanism remains a mystery. One hypothesis is that keloids are formed as a result of underlying skin tension. Numerous grafts have been used to decrease skin tension after keloid excision, but recurrence rates typically remain high. Materials and Methods: This prospective, nonrandomized clinical intervention study examined the results of Integra artificial dermis grafting in preventing keloid recurrence in patients who presented to an academic otolaryngology/facial plastic surgery office. Results: Two patients underwent the procedure, but because of the high recurrence rate and the poor cosmetic outcome, the study was terminated early. All patients had signs of recurrence by the 3-month follow-up visit. One patient served as her own control and had earlier and more severe recurrence at the site where the Integra was used. Discussion: Integra artificial dermis grafting fails to prevent keloid recurrence following excision. This study suggests that increased skin tension may not play an integral role in keloid formation.