Study On Clinical Application Of Two Surgical Procedures For Ear Keloid

Objective(s):To study the clinical application of total excision and core excision of ear keloid.Methods:31 patients with keloid were selected from the Department of plastic surgery of the first affiliated Hospital of Kunming Medical University from January 2018 to January 2019.A total of 34 keloids were followed up.Patients’ age,the growth time and the maximum diameter of keloid were recorded before treatment.Group A included 15 patients with 15 keloids,which were treated with total excision of keloid.Group B included 16 patients with 19 keloids,who were treated with core excision of keloid.Both group were treated with the same radiotherapy regimen.The complications were recorded and followed up to 1 year after operation.The changes of Vancouver Scar Scale(VSS)before and 1 year after operation were compared and statistically analyzed to evaluate the effects of different treatment and to identify the indications and key points of operation.Results:The average age of group A was 23.07±4.37 years old,and 22.89±4.89 years old of group B,the difference was not statistically significant(p>0.05).The scar growth time was 17.73±3.49 months in group A and 17.47±5.08 months in group B,the difference was not statistically significant(p>0.05).The maximum diameter of keloid in group A was 1.65±0.62cm and 2.51±1.14cm in group B,the difference was statistically significant(P<0.05).The keloid in group A was smaller than group B.The VSS score of group A before and 1 year after operation was 12.60±2.09 and 5.47±1.55,and the difference was statistically significant(P<0.05).As for group B,It’s 12.05±1.84 before operation and 4.84±1.97 one year after operation,the difference was statistically significant(P<0.05).There was no statistically significant(p>0.05)between the two groups in the VSS score of before operation,as well as 1 year after operation.The common complications were pruritus,pain and wound bleeding.There was no significant difference in the incidence between the two groups(p>0.05),During the follow-up period,1 patient in group A relapsed as well as group B.Conclusion(s):1.Both of the two surgical procedure can effectively treat keloid.2.There is no difference between total excision and core excision in the treatment of keloid in 5cm.Considering the tension and the shape of auricle,total excision is recommended for small ear keloid(diameter≦2cm)or keloid with pedicle.For the larger ear keloid(maximum diameter>2cm),it is recommended to perform core excision and cover the wound with keloid epidermis,which can better reconstruct the appearance of ear,reduce the tension and avoid the risk of scar formation in the donor area faced by skin grafting or flap transplantation.