Barreiro D, Mendes M, Machado P, Gomes S, Soares P, Horta R
Department of Plastic and Reconstructive Surgery, Centro Hospitalar São João, Porto, Portugal.
Faculty of Medicine, University of Porto, Portugal.
Ann Burns Fire Disasters. 2025 Mar 31;38(1):59-65. eCollection 2025 Mar.
Keloid is a benign dermal condition that occurs due to excessive activation of fibroblasts, which leads to an abnormal accumulation of collagen. There are several treatment options, but none have been satisfactory or optimal. Often, combined treatments are used due to its high recurrence rate after surgical excision alone. The aim of this study is to evaluate the efficacy of adjuvant radiotherapy after surgical excision. A retrospective study was performed including patients with keloid scars who underwent surgical excision and adjuvant radiotherapy between May 2016 and March 2020. The data was collected from the radiotherapy and plastic surgery medical charts. There were 13 patients identified. The patient and observer scar assessment scale (POSAS) was performed in all 13 patients. The treatment used was surgical excision of the scar associated with 9 Gy radiotherapy dose within the first 24 hours after the surgery, plus another session after 7 days. 13 patients and 16 keloid scars were evaluated during a mean follow-up period of 13,5 months 95%CI (5,84; 21,16). There was no major adverse event from the treatment used. According to POSAS, the overall satisfaction rate was significantly good (mean of 2,29 on a scale from 1 to 10). Only one recurrence was observed (6.25%). Keloids are difficult to treat due to their high recurrence rate. There is no consent about the best treatment. This study showed that surgical excision combined with adjuvant radiotherapy is an excellent option, even for refractory keloids. The aesthetical result was satisfactory and the recurrence rate was low.
瘢痕疙瘩是一种良性皮肤疾病，由于成纤维细胞过度活化导致胶原蛋白异常堆积而发生。有多种治疗选择，但均未达到令人满意或最佳的效果。由于单纯手术切除后复发率高，通常采用联合治疗。本研究的目的是评估手术切除后辅助放疗的疗效。进行了一项回顾性研究，纳入2016年5月至2020年3月期间接受手术切除和辅助放疗的瘢痕疙瘩患者。数据从放疗和整形手术病历中收集。共确定了13例患者。对所有13例患者进行了患者和观察者瘢痕评估量表（POSAS）评估。治疗方法为手术切除瘢痕，并在术后24小时内给予9 Gy放疗剂量，7天后再进行一次放疗。在平均13.5个月的随访期内（95%CI：5.84；21.16）对13例患者和16个瘢痕疙瘩进行了评估。所用治疗未出现重大不良事件。根据POSAS，总体满意率显著良好（1至10分制平均为2.29分）。仅观察到1例复发（6.25%）。瘢痕疙瘩因其高复发率而难以治疗。对于最佳治疗方法尚无共识。本研究表明，手术切除联合辅助放疗是一种极佳的选择，即使对于难治性瘢痕疙瘩也是如此。美学效果令人满意，复发率低。
