How to treat and manage keloids
28-03-2018, 16:19
Post: #1
How to treat and manage keloids
I found this somewhere through my endless keloid research i hope it helps some one.


A KELOID. Treatment is more successful if you start it early.

A developing keloid. Within a month or two of the injury: (1) Apply pressure. (2) Inject a suspension of hydrocortisone, about 2 ml at each site spread out subcutaneously. Or, better, use triamcinolone. Give 4 injections 3 weeks apart.

An established keloid. Steroids have no effect. Resist the request to operate if you can. The worse the keloid, the more likely it is to recur if you excise it. If you are pressed, excise smaller ones, but be sure to explain that they may recur and may even be worse.

If you operate, excise the abnormal tissue within the keloid, leaving a margin of keloid tissue all round. Keep your sutures within this margin also. If necessary, graft the bare area. You may be able to shave skin off the keloid and use this as a graft. All this is difficult; so is closing the wound tidily. Complete the incision and then inject steroid suspension into the scar. Postoperatively give him 4 more steroid injections at 3-weekly intervals. Apply a pressure bandage or an elastic garment for 9 months[md]if he will accept it!

Keloids are easier to remove from convex than from concave surfaces. A protruding keloid usually extends downwards like a saucer into the subcutaneous fat. Shave it off a little above the skin level, remaining within the keloid tissue and without entering the subcutaneous fat. Control bleeding, and apply a complete sheet of split skin extending beyond the margins of the keloid.

CAUTION ! (1) Try to avoid operating on established keloids. (2) Use a sharp knife. (3) Don't pull on the keloid as you excise it, or you may enter the subcutaneous tissue. Instead, if necessary, depress the surrounding tissues. (3) Don't use sutures.

Don't mistake them for a sarcoma! If there is any doubt about the diagnosis, send a piece for histology.


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