A retrospective analysis of surgical resection of large ear keloids

Optimizing Surgical Procedures of Auricular Keloids According to Their Anatomic Morphological Features

BACKGROUND

Aesthetic surgical reconstruction of auricular keloids is still a conundrum. This study introduces our experiences in analyzing the anatomic morphological features of auricular keloids, and devising optimized surgical procedures accordingly.

METHODS

A total of 129 ears with auricular keloids were classified and operated. All patients were followed up for at least 12 months.

RESULTS

According to their anatomic positions, auricular keloids were divided into 3 Groups (A, B, and C). The morphological features of keloids were further interpreted according to Chang-Park classification of earlobe keloids. The authors optimized surgical procedures according to the anatomic morphological features from a range of surgical techniques. The recurrence rate of Group C was statistically higher than Group A and B. There was no significant difference in recurrence rate between keloids treated with "primary suture" and "filleted flaps."

CONCLUSIONS

According to the anatomic positions and morphological features of auricular keloids, we could conveniently devise optimized surgical strategies to obtain aesthetic reconstruction of auricular keloids.

The Effects of Timing of Postoperative Radiotherapy on Hypertrophic Scar in a Rabbit Model

Background

Hypertrophic scar is associated with excessive proliferation of fibroblasts, the accumulation of collagen fibers, and angiogenesis associated with chronic inflammation. Scar resection, combined with radiotherapy, is widely used in clinical practice, but timing remains controversial. This study aimed to investigate the association between the timing of postoperative radiotherapy and the effects on hypertrophic scar in a rabbit model.

Material/Methods

Forty New Zealand white rabbits, 8–12 months old, weighing 1.8–2.3 kg were used in the model of hypertrophic scar and underwent surgical resection with or without postoperative radiotherapy. The study groups included: Group 1, the non-resection group; Group 2, the resection and non-radiotherapy group; Group 3, the immediate postoperative radiotherapy group; Group 4, the 12-hour postoperative radiotherapy group; Group 5, the 24-hour postoperative radiotherapy group; Group 6, the 48-hour postoperative radiotherapy group; Group 7, the 72-hour postoperative radiotherapy group; and Group 8, the 120-hour postoperative radiotherapy group. The rabbit ear skin was observed after treatment, and the hypertrophic scar index (HI), fibroblast numerical area density (NA), and collagen fiber area density (AA) were determined.

Results

The HI, NA, and AA were significantly lower after 48 hours of postoperative radiotherapy (P<0.05), with the effects occurring mainly within 24 hours. There was no difference in HI, NA, and AA between the radiotherapy and non-radiotherapy groups within 24 hours after surgery.

Conclusions

In a rabbit model of hypertrophic scar, surgical resection combined with radiotherapy resulted in an optimal effect within 24 hours after surgery.