Keloid Excision

Video Type: CVideo
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Author: Michael Golinko
Published:
Specialties: Pediatric Surgery, Plastic Surgery
Schools:
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Basic Info

Bilateral ear keloid excision with steroid injection.

DOI# 10.17797/rfealpdd24

Advanced

Procedure

Excision of recurrent hypertrophic scar / keloids with steroid injection.

Indications

Recurrent ear keloid / hypertrophic scar, to restore normal ear lobe contour, pain, swelling, cosmesis.

Contraindications

Patient desire, recent targeted radiation therapy or systemic chemotherapy.

Instrumentation

Setup

General anesthesia, head wrap exposing both ears, mark area of excision 2mm outside keloid scar, inject with local anesthetic with epinephrine before cleaning site with betadine to allow time for vasoconstriction.

Preoperative Workup

History & Physical Exam, CBC, Coagulation Profile, CMP, Anesthesia ASA Categorization.

Anatomy and Landmarks

Recognition of where the earlobe ends and inferior helix lower cartilage begins. Differentiating epithelial and dermal skin layers from cartilaginous skin.

Advantages/Disadvantages

Advantage of double ellipse scoring first with 15 blade, and then through-and-through.

Complications/Risks

Bleeding, infection, seroma, recurrent keloiding.

Disclosure of Conflicts

Bleeding, infection, seroma, recurrent keloiding.

Acknowledgements

References

Robles DT, Moore E, Draznin M, et al. Keloids: pathophysiology and management. Dermatology Online J. 2007;13:9

Ogawa R. The most current algorithms for the treatment and prevention of hypertrophic scars and keloids. Plast Reconstr Surg. 2010;125:557-568

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