KELOIDS: COMBINED THERAPEUTIC SOLUTIONS

Keloids are, pathological painful scars, prominent and proliferating beyond the original wound shape, which recur after surgical excision. Their aetiology is much debated, and many hypotheses have been put forward. No single known cause exists, but many factors that modify and increase the normal wound-healing process have been considered as probably involved in the genesis of keloids; for this reason many different therapeutic approaches directed towards each of the causing factors are used.
Methods. Considering the different therapeutic strategies and the physiopathological mechanisms they contrast, we found the most promising solution in the association of surgery, postoperative radiotherapy and compressive dressings with silicone gel sheeting.
Results. Seven out of 11 keloids (9 patients) treated in this way did not recur after an observation period of 2 months - 3 years; 1 patient developed a hypertrophic scar 18 months after surgery, that underwent regression after a 3-month treatment with silicone gel sheeting; 3 keloids recurred 3-5 months after their excision.
Conclusion. Considering the results obtained in this limited number of patients, we believe that the association of surgery, radiotherapy and compressive silicone dressings represents a possible combined treatment modality that deserves some consideration, and that needs to be verified on greater populations in further studies