Ways to Improve the Results of Treatment of Patients With Keloid Scars on the Face

Facial keloid scars pose a serious clinical and psychosocial problem associated with excessive fibroproliferation, chronic inflammation, and significant visual severity of the lesion. Despite the active use of surgical excision, the recurrence rate with monotherapy remains high, which necessitates combined treatment using modern adjuvant techniques. The objective is to improve the effectiveness of surgical treatment of patients with keloid facial scars by analyzing the effectiveness of modern surgical methods of correcting deformities of the frontal area, as well as evaluating the clinical and aesthetic results of combined treatment using surgical and adjuvant techniques. Material and Methods. The experience of surgical correction of keloid scars on the face, performed at the Valikhnovski Surgery Institute (Kyiv, Ukraine), and the analysis of the relevant achievements of reconstructive plastic surgery are described. The author's technique of three-layer suturing using non-absorbable monofilament suture material, postoperative compression, and exclusion of local steroids were applied. Statistical analysis of the data was performed using SPSS and Excel, the significance level was p < 0.05. Results. In the presented clinical case, complete regression of keloid tissue, normalization of facial contours and reduction of inflammation were observed without the use of topical or injectable steroids. The results of treatment of other patients using variations of surgical suturing also demonstrated improvement in functional and aesthetic parameters. The combined strategy of surgery, compression, and withdrawal of local immunomodulatory agents in a number of cases reduced the risk of recurrence. Conclusions. Comprehensive individualized treatment of facial keloid scars, taking into account the localization, tissue tension and morphology of the lesion, can reduce the frequency of recurrence and achieve a stable aesthetic result. The choice of suturing technique, adequate compression support, and reasonable use of adjuvants are crucial for a successful surgical strategy.