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Abstract
Aim: To evaluate the clinical efficacy of scar split-thickness skin replantation combined with LCR (laser-carbon dioxide-radiotherapy) therapy in improving healing outcomes and reducing recurrence rates in patients with multiple nodular or hypertrophic keloid lesions.
Methods: A retrospective review was conducted on 11 patients who underwent surgical excision of keloids, followed by replantation of split-thickness skin graft onto the thinned keloid dermis. Postoperatively, all patients received LCR therapy. Clinical outcomes were assessed using the Patient and Observer Scar Assessment Scale (POSAS) before and after treatment. Postoperative epithelialization time and adverse events were also recorded.
Results: All patients achieved complete epithelialization within four weeks after surgery. Significant improvement in scar quality was observed, with POSAS scores decreasing from 92.35 ± 6.09 pre-treatment to 18.58 ± 7.38 post-treatment (P < 0.001). No severe complications such as infection or ulceration occurred during the follow-up period.
Conclusion: Scar split-thickness skin replantation combined with LCR therapy is a safe, cost-effective, and efficacious treatment modality for keloids. By preserving the dermal scaffold and enhancing epithelial regeneration, this approach significantly improves scar appearance and reduces recurrence, particularly in challenging cases involving multiple or hypertrophic keloid nodules.
Keywords
Keloid
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scar split-thickness skin graft replantation
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LCR therapy
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wound healing
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Wenbo Wang, Zongan Chen, Lingling Xia, Zhen Gao, Xiaoli Wu.
Retrospective analysis of keloid split-thickness skin graft replantation combined with LCR therapy for keloid treatment.
Plastic and Aesthetic Research, 2025, 12(1): 26 DOI:10.20517/2347-9264.2025.43
| [1] |
Jeschke MG,Middelkoop E.Scars.Nat Rev Dis Primers2023;9:64
|
| [2] |
Huang C,Bai J,Ogawa R.Fibroproliferative conditions: the 3R approach bridging fibrosis and tumors.Trends Mol Med2025;Epub ahead of print:
|
| [3] |
Shih B,McGrouther DA.Molecular dissection of abnormal wound healing processes resulting in keloid disease.Wound Repair Regen2010;18:139-53
|
| [4] |
Lee YI,Ham S.Heterogeneity in keloid scars: influence of mechanical stretching on keloids arising from different anatomical sites.J Invest Dermatol2025;145:710-3.e7
|
| [5] |
Andrews JP,Macarak E,Uitto J.Keloids: the paradigm of skin fibrosis - pathomechanisms and treatment.Matrix Biol2016;51:37-46 PMCID:PMC4842154
|
| [6] |
Ogawa R.Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis.Int J Mol Sci2017;18:606 PMCID:PMC5372622
|
| [7] |
Limandjaja GC,Scheper RJ.The keloid disorder: heterogeneity, histopathology, mechanisms and models.Front Cell Dev Biol2020;8:360 PMCID:PMC7264387
|
| [8] |
Fu S,Zhong Y.Comparison of surgical excision followed by adjuvant radiotherapy and laser combined with steroids for the treatment of keloids: a systematic review and meta-analysis.Int Wound J2024;21:e14449 PMCID:PMC10895202
|
| [9] |
Liao C,Zeng Q.Piezo1-mediated calcium flux transfers mechanosignal to yes-associated protein to stimulate matrix production in keloid.J Invest Dermatol2025;Epub ahead of print:
|
| [10] |
Akaishi S,Ogawa R.The relationship between keloid growth pattern and stretching tension: visual analysis using the finite element method.Ann Plast Surg2008;60:445-51
|
| [11] |
Wang W,Xia L.An innovative single-stage approach of high-tension keloid excision and reconstruction using acellular dermal matrix and epidermal skin grafting.Dermatologic Therapy2024;2024:7551111
|
| [12] |
Ma QY,Chen ZA.Laser combined with radiotherapy for keloid treatment: a novel and efficient comprehensive therapy with a lower recurrence rate.Plast Reconstr Surg2023;152:1022e-9
|
| [13] |
Limandjaja GC,Scheper RJ.Hypertrophic scars and keloids: overview of the evidence and practical guide for differentiating between these abnormal scars.Exp Dermatol2021;30:146-61 PMCID:PMC7818137
|
| [14] |
Ogawa R.Mechanobiology of scarring.Wound Repair Regen2011;19:s2-9
|
| [15] |
Gauglitz GG,Pavicic T,Jeschke MG.Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies.Mol Med2011;17:113-25 PMCID:PMC3022978
|
| [16] |
Ogawa R,Akaishi S,Iimura T.Reconstruction after anterior chest wall keloid resection using internal mammary artery perforator propeller flaps.Plast Reconstr Surg Glob Open2016;4:e1049 PMCID:PMC5055023
|
| [17] |
Liu H,Liu S,Hao Y.Large chest keloids treatment with expanded parasternal intercostal perforator flap.BMC Surg2021;21:147 PMCID:PMC7981883
|
| [18] |
Hou S,Chen XD.The clinical efficacy of punch excision combined with intralesional steroid injection for keloid treatment.Dermatol Surg2023;49:S70-4
|
| [19] |
Park TH.Successful use of a 2-mm punch device in a patient with massive, multiple keloids.Dermatol Surg2025;51:215-6
|
| [20] |
Hwang NH,Lee NK.Effect of the biologically effective dose of electron beam radiation therapy on recurrence rate after keloid excision: a meta-analysis.Radiother Oncol2022;173:146-53
|
| [21] |
Azzam OA,El-Hawary MS,Sobhi RM.Treatment of hypertrophic scars and keloids by fractional carbon dioxide laser: a clinical, histological, and immunohistochemical study.Lasers Med Sci2016;31:9-18
|
| [22] |
Lee JW.Adjuvant radiotherapy after surgical excision in keloids.Medicina2021;57:730 PMCID:PMC8306494
|
| [23] |
Caviggioli F,Vappiani M,Maione L.Evidence-based scar management: how to improve results with technique and technology.Plast Reconstr Surg2017;139:1371e-3
|
| [24] |
Ekstein SF,Moran SL.Keloids: a review of therapeutic management.Int J Dermatol2021;60:661-71 PMCID:PMC7940466
|
| [25] |
Jiao H,Fan J.The superficial dermis may initiate keloid formation: histological analysis of the keloid dermis at different depths.Front Physiol2017;8:885 PMCID:PMC5682018
|