Frequency of keloid recurrence post-surgical excision and radiation therapy on a 2-year follow-up: A single center cohort study.

Background: Keloids are elevated, painful scars that extend beyond the original wound's boundaries and can cause significant emotional distress for patients. While combining surgical excision with radiation therapy has shown potential in treating these scars, its effectiveness in local populations remains unclear. Methods and Methodology: The study was conducted from January 2015 to December 2019 in the Plastic Surgery Department at a tertiary care hospital in Karachi, Pakistan. Twenty-five patients who were treated at the hospital were recruited, while 17 out of 25 fulfilling the inclusion criteria were selected. Patients were treated according to a defined treatment protocol and evaluated after a 2-year follow-up. A survey questionnaire was administered after obtaining consent from the patients via telephonic interviews at a 2-year follow-up. Result: Out of 25 patients, 17 (68%) met eligibility criteria, eight (32%) were excluded due to lack of follow-up. The patients that presented with keloids, were seven (41%) males and 10 (59%) females. Six (35%) had a family history of keloids. Etiological factors included injury/trauma (n=9, 53%), spontaneous growth (n=6, 35%), and wound site growth (n=2, 12%). Recurrence post-surgery and radiation therapy occurred in 11 (65%) cases, while seven (35%) remained recurrence-free over 24 months. Recurrence frequency was noted in six (55%) patients within six months, three (27%) within 12 months, and two (18%) within 24 months. Conclusion: Keloid management is a complex field requiring ongoing research to optimize treatment strategies, reduce recurrence rates, and improve patient outcomes through evidence-based protocols in the Pakistani population. Lay summary: In a recent study conducted at a tertiary care hospital in Karachi, Pakistan researchers investigated the frequency of keloid recurrence following surgical removal and radiation therapy over a period of two years.Keloids are a type of raised scar that can form after an injury or surgery, often causing discomfort and aesthetic concerns for patients.The study aimed to understand how often keloids come back after treatment, particularly when surgery and radiation therapy are combined. This approach is commonly used to manage keloids, but its effectiveness in preventing recurrence over the long term is not fully understood.Over the two-year follow-up period, the researchers tracked a group of patients who had undergone surgical excision (removal) of their keloids followed by radiation therapy. They observed how many of these patients experienced the return of keloids at the site of the original scar.By analyzing the data, the researchers were able to determine the frequency of keloid recurrence in this specific group of patients. This information is important for healthcare providers and patients considering treatment options for keloids, as it helps to better understand the potential outcomes and risks associated with surgical excision and radiation therapy.Overall, the study provides valuable insights into the management of keloids and contributes to our understanding of the long-term effectiveness of combined surgical and radiation therapy in reducing the recurrence of these troublesome scars.