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Erschienen in:
27.11.2015 | Original Paper
Cryotreatment of keloids: a single Italian institution experience
Erschienen in: European Journal of Plastic Surgery | Ausgabe 3/2016
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Background
Keloids are pathologic scars that can cause significant aesthetic disfiguration and symptoms. There are no specific causing factors, and a common consensus on their management has not been reached. This study provides an evaluation of the efficacy of cryotherapy and cryosurgery in their treatment.
Methods
Patients with keloids who were hospitalized at the Plastic Surgery Unit, University of Turin, were submitted to cryotreatment. A significant sample of 153 patients with 192 lesions, treated between 2009 and 2013, was considered for the purpose of this study. The protocols chosen were outpatient cryotherapy sessions and cryosurgery (surgical shaving combined with cryotherapy). Reductions of the scar volume and thickness, together with the reduction of clinical symptoms, were assessed.
Results
On average, the follow-up was 12–72 months. In 83 % of patients who received outpatient cryotherapy, there was a diminishment of 75–82 % in the size of the lesions, with an average of 5–10 applications needed. In 94 % of those submitted to cryosurgery, one session was enough to achieve an almost complete smoothing (reduction in lesions sizes higher than 80 %). However, 13 % of the patients submitted to cryosurgery also needed sessions of outpatient cryotherapy to achieve effective results. For both approaches, the main adverse effects included dyschromia with healthy skin and dystrophic scars. No recurrence was observed.
Conclusions
Our experience confirms the cryotreatment among first-line monotherapies against keloids, in terms of therapeutic effectiveness, safeness, costs, and ease of application. A careful selection of the protocol treatment on the base of the lesion characteristics (age and the morphology) and a good compliance of patients are necessary to reach optimal results.
Level of Evidence: Level IV, therapeutic study.