Keloid Excision

Bilateral ear keloid excision with steroid injection.

DOI# 10.17797/rfealpdd24

Excision of recurrent hypertrophic scar / keloids with steroid injection.
Recurrent ear keloid / hypertrophic scar, to restore normal ear lobe contour, pain, swelling, cosmesis.
Patient desire, recent targeted radiation therapy or systemic chemotherapy.
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.
History & Physical Exam, CBC, Coagulation Profile, CMP, Anesthesia ASA Categorization.
Recognition of where the earlobe ends and inferior helix lower cartilage begins. Differentiating epithelial and dermal skin layers from cartilaginous skin.
Advantage of double ellipse scoring first with 15 blade, and then through-and-through.
Bleeding, infection, seroma, recurrent keloiding.
Bleeding, infection, seroma, recurrent keloiding.
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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