Keloid Excision With Primary Closure Combined With Superficial Radiation Therapy (SRT-100).

Background: Surgery plus radiotherapy is associated with fewer recurrences after keloid treatment. However, the side effects of radiotherapy are of concern. Superficial radiation therapy has a low energy, targets the skin, and spares deeper structures, making it ideal for keloid treatment. Many studies have reported good outcomes after surgery combined with superficial radiation therapy. This study provided data on Taiwanese patients who underwent keloid excision with simple primary closure and superficial radiation therapy.

Methods: We retrospectively collected data from patients who underwent keloid excision with postoperative radiotherapy at our hospital. All patients underwent keloid excision and primary wound closure without Z-plasty or a local flap. Subsequently, patients underwent 2 or 3 fractions of superficial radiation therapy (SRT) on postoperative days 0, 1, and 2 (in 3 fractions). We collected data on the patients' preoperative Vancouver Scar Scale (VSS), 2-month follow-up VSS score, recurrence, and side effects.

Results: In total, 16 keloids in 12 patients were treated with excision, primary closure, and superficial radiation therapy. The mean preoperative VSS was 8.69 ± 1.79, whereas the mean 2-month postoperative VSS was 3.56 ± 0.70. Most of the keloids were followed up for more than 6 months. No keloid recurrence was observed. A side effect of radiotherapy is hyperpigmentation of the skin surrounding the surgical scar.

Conclusions: Keloid excision with primary closure combined with postoperative SRT leads to a good outcome with no recurrence and a shorter incision wound that satisfies patients and reduces the complications of hyperpigmentation.