Surgical Treatment of Burn Induced Helical Keloid with Excision and Full-Thickness Skin Grafting

Chung, Ji Hee; Burm, Jin Sik; Lee, Jong Wook; Jang, Young Chul; Oh, Suk Joon

Abstract

Burn induced helical keloid is usually manifested by the severe disfigurement. The satisfactory reconstruction of the helical rim has not been achieved by the methods such as full thickness skin grafting(FTSG), core extirpation, and simple excision combined with intralesional steroid injection. In treatment with FTSG, the frequent failure of skin graft in the helical rim is due to the lack of adequate vascular supply in the recipient bed and the exposed helical cartilage after keloid excision. However, if the recipient bed with rich vascularity is widen and sufficient to maintain the viability of the graft, FTSG is the best method that leaves less donor morbidity and is able to reconstruct the natural appearance of helix. We proposed that the improved survival of skin graft could be achieved by better vascular supply by the deepithelialization of the surrounding normal skin after keloid excision. Five helical burn keloids and hypertrophic scars were reconstructed by the method of excision and FTSG. There were no recurrence and the results showed good texture and similar skin color. Excision of scar and FTSG is a satisfactory method to treat helical burn keloid.