Zhang Yi, Wang Chen, Lyu Dongze, Wang Danru, Zhou Renpeng
Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.
Aesthetic Plast Surg. 2025 Apr;49(7):2097-2103. doi: 10.1007/s00266-024-04574-1. Epub 2024 Dec 3.
The chest, with its high skin tension, is prone to keloids and has a high relapse rate. Surgical excision of keloids combined with radiation therapy significantly reduces the recurrence rate. For larger chest keloids (3-10 cm), intercostal artery perforator propeller flap can be used to reduce tension. However, there is a lack of reports of long-term complications of this treatment.
The keloid excision using intercostal artery perforator propeller flap was performed for patients with anterior chest keloid between Oct 2018 and Aug 2022. Then radiation therapy was given in 6 Gy each time in 3 fractions over 3 days (electron beam irradiation) for a total dose of 18 Gy. All patients were followed up for at least 24 months. The complications were recorded and analyzed.
A total of 15 patients with anterior chest keloid underwent surgery and radiation therapy. Satisfactory aesthetic outcomes were achieved. The recurrence rate was 0%. The major complication observed in our patients was a hypertrophic scar (86.7%), followed by hyperpigmentation (13.3%).
The major complication of our patients is the hypertrophic scar, followed by hyperpigmentation. Patients should be fully informed of the risk of this long-term complication (hypertrophic scar) preoperatively.
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胸部皮肤张力高，易形成瘢痕疙瘩且复发率高。瘢痕疙瘩手术切除联合放射治疗可显著降低复发率。对于较大的胸部瘢痕疙瘩（3 - 10厘米），可使用肋间动脉穿支推进皮瓣来减轻张力。然而，关于这种治疗的长期并发症的报道较少。
对2018年10月至2022年8月期间的前胸瘢痕疙瘩患者采用肋间动脉穿支推进皮瓣进行瘢痕疙瘩切除。然后进行放射治疗，每次6 Gy，分3次在3天内完成（电子束照射），总剂量为18 Gy。所有患者至少随访24个月。记录并分析并发症情况。
共有15例前胸瘢痕疙瘩患者接受了手术和放射治疗。获得了满意的美学效果。复发率为0%。观察到的主要并发症是增生性瘢痕（86.7%），其次是色素沉着（13.3%）。
我们患者的主要并发症是增生性瘢痕，其次是色素沉着。术前应充分告知患者这种长期并发症（增生性瘢痕）的风险。
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