Surgical Treatment for Chest “Lock” Keloid Using Autologous Split-Thickness Skin Grafting and Postoperative Radiotherapy

BACKGROUND The treatment of chest “lock” keloids is challenging due to skin defects and a high recurrence rate. OBJECTIVE Evaluation of the effectiveness of autologous split-thickness skin graft with local radiotherapy for treating chest “lock” keloids. METHODSAND MATERIALS Fifty-seven patients with chest “lock” keloids were treated from July 2018 to September 2020. The skin defects were closed with an autologous split-thickness skin graft (STSG) and vacuum sealing drainage. The donor and the recipient sites received the first session of radiotherapy 72 hours postoperation for 3 consecutive days. Patients underwent follow-up examinations 12 months after surgery. The Patient and Observer Scar Assessment Scale (POSAS) was used to assess the treatment outcome. RESULTS Except for the complaints of pain, which did not improve in the patients' assessments ( p = .368), POSAS improved significantly after treatment ( p < .0001). The cure rate (including cured and partially cured scars) was 100%. No keloid recurrence was observed during the follow-up period. CONCLUSION The procedure of treating chest “lock” keloid by keloid debulking and autologous STSG followed by postoperational radiotherapy is a novel combined methodology for treating keloids.