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Keloid Intralesional Excision (KILE) Reduces Recurrence, a Meta-Analytic Study of the Available Literature On 608 Keloids
Nathan Lawera, Jules Madzia, Kiersten Woodyard, Liann Casey, Lane Guyton, Angelo Leto Barone, Brian S. Pan
University of Cincinnati
2023-01-31
Presenter: Liann Casey
Affidavit:
The abstract in question has been authored by the resident in collaboration with coresidents and medical students listed. It is original work that has not previously been presented at a major meeting or been published by a scientific journal.
Director Name: Ann Schwentker
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Objective: The objective of this meta-analysis was to examine the reliability of keloid treatment by intralesional excision.
Background: Treatment of keloids with surgical excision alone leads to high rates of recurrence. There are many methods used to treat keloids but there are no standardized guidelines. This study seeks to evaluate, what we believe is an underutilized method of managing these difficult scars, intralesional excision.
Methods: A computer search of the PubMed database was performed. After a review of the studies by two independent investigators, twenty-three studies met the inclusion criteria. Incidence of keloid recurrence was recorded and comprehensive meta-analysis software was used to assess the pooled keloid recurrence rate, as well as the effect of additional therapies.
Results: Twenty-three studies evaluating intralesional excision of 608 keloids were analyzed. The pooled recurrence rate was 13% (95% CI: 9-16%). There was no evidence that using therapies in addition to intralesional excision had a significant effect on the overall pooled effect size.
Conclusions: We conclude that intralesional excision is an effective technique for keloid excision, with recurrence rates that are much lower than those reported after complete excision. In our study, the use of adjuncts to intralesional excision does not appear to have a significant effect on the likelihood of recurrence. Given that there are currently no standard guidelines for keloid treatment, this finding has important implications for surgical practices in keloid excision in the United States and abroad.
