Surgical treatment of keloid and hypertrophic scars
Last reviewed: 23.04.2024
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The excision of a keloid scar in combination with conservative treatment is advisable in those cases when the keloid scar has small transverse dimensions on one side and extends considerably above the surface of the skin on the other. The technique of excising the keloid cicatrix has the following features:
- operative intervention must be carried out so that the skin itself is not affected by any tools;
- infiltration of tissues with an anesthetic solution is carried out so that the points of needle sticking are located on those parts of the skin that will be removed; in people prone to keloidosis, needle injection is done only along the line of the future incision;
- the cut is performed with a sharp scalpel to the depth of the subcutaneous layer in one motion, so that the plane of the cut of the dermis is as smooth as possible;
- Cut the skin with scissors is prohibited;
- when the margins are cut, the wounds are lifted by hooks only over the layer of subcutaneous fat;
- to sew a wound it is possible only when it is possible to reduce its edges easily;
- when it is impossible to sew a wound into a line, apply a free skin graft;
- additional incisions for plastics with rags on the feeding stem are not recommended;
- Nodal seams on the skin should not be applied, only a continuous subcutaneous suture is used; To more accurately compare the edges of the wound, stripes of the plaster are used (Steri-strip);
- In the postoperative period immobilization of tissues in the intervention zone is necessary;
- 1 month after the operation, the Kenalog injection course begins, after which end the external use of the plates "Epiderm" begins.
In the treatment of 32 patients using this complex approach, a stably good result was obtained in 9 2% of cases.
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