Outcomes of omega variant keystone flap in conjunction with single fraction radiotherapy for helical keloids: A comprehensive one-year follow-up study

Park, Tae Hwan

doi:10.1016/j.bjps.2023.09.006

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…6,7 The keystone flap has proven its simplicity and versatility over a few decades. 6,[8][9][10][11][12] Nevertheless, using a keystone flap in the scalp is rarely discussed previously. Most of the previous articles addressing keystone flap in the scalp are at the more mobile area, such as the junction of scalp and forehead or scalp and posterior neck, or temporal region, which is mainly supplied by definite source vessels such as superficial temporal artery/vein.…”

Section: Discussionmentioning

confidence: 99%

How to Safely Use the Perforator-based Keystone Island Flap in the Scalp: Basal Cell Carcinoma of the Scalp With Local Invasion to Calvarium

Park,

Lee,

Kim

2024

Journal of Craniofacial Surgery

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Scalp reconstruction has always been a challenging problem for even the most experienced surgeon to provide good aesthetic and functional results. This is mainly because the scalp is less mobile and tight, requiring a much larger dissection for the size of the original defect. We hypothesized that the omega variant perforator-based keystone island flap at the subgaleal plane provides a versatile and easily reproducible reconstructive option for scalp reconstruction after wide skin cancer excision. We reviewed all patients who underwent reconstruction with the keystone flap or its modification to repair scalp defects following wide resection of skin cancer in the scalp abutting calvarium from May 2021 to July 2023. We designed the flap width 50% wider than original keystone flap design first introduced by Dr. Behan. We reconstructed medium- to large-sized scalp defects ranging from 2×2 to 5×5 cm2 using an omega variant perforator-based keystone island flap. All patients were satisfied with the aesthetic outcomes without complications. Keystone flaps are a versatile option for reconstructing the scalp after cancer resection. This strategy obviates the need for skin grafting, myocutaneous flap or free flap after cancer removal in the scalp.

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Section: Discussionmentioning

confidence: 99%

How to Safely Use the Perforator-based Keystone Island Flap in the Scalp: Basal Cell Carcinoma of the Scalp With Local Invasion to Calvarium

Park,

Lee,

Kim

2024

Journal of Craniofacial Surgery

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“…All patients received a single dose of 10 Gy to the 93% to 95% isodose line, with a corresponding biologically equivalent dose of 20 Gy (α/β of 10). Alternatively, based on a large meta-analysis depicting keloids as late-responding tissue, the biologically equivalent dose (BED) was calculated as 60 Gy (α/β of 2), as previously described 7–10 …”

Section: Methodsmentioning

confidence: 99%

“…Alternatively, based on a large meta-analysis depicting keloids as late-responding tissue, the biologically equivalent dose (BED) was calculated as 60 Gy (α/β of 2), as previously described. [7][8][9][10]…”

Section: Adjuvant Radiation Therapymentioning

confidence: 99%

Efficacy of Immediate Postoperative Single Fractional 10 Gy Radiotherapy for Earlobe Keloids

Han,

Ha,

Chang

et al. 2024

Journal of Craniofacial Surgery

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Background: The ear is a common site for keloid formation, typically due to ear piercing or trauma. Auricular keloids are always difficult to treat and pose a challenging situation. The purpose of this study is to present our experience treating earlobe keloids through complete surgical excision followed by immediate postoperative single fraction 10 Gy radiation therapy either on the same day or the next day. Methods: The authors retrospectively evaluated 48 patients with 71 earlobe keloids treated with complete surgical excision followed by single‐fractional 10 Gy radiotherapy within 24 hours from May 2021 to December 2022. The outcome was reported with a recurrence‐free rate and side effects. Results: The mean follow‐up period was 20.8 months. All patients tolerated the treatments well. The overall recurrence‐free rate was 100%. There were only 2 grade III radiation dermatitis. There were no reports of second malignancies or severe complications. Conclusions: The authors have obtained excellent outcomes from treating earlobe keloids through complete excision followed by postoperative radiotherapy with a single fractional dose of 10 Gy on the same day or the next day.

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A Comparative Analysis of Postoperative Single Fraction of 9.5 Gy Versus 10 Gy for Ear Keloids

Kang,

Ha,

Park

2024

Dermatol Surg

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BACKGROUND The optimal radiotherapy doses for postoperative treatment of ear keloids are currently a topic of debate. OBJECTIVE The authors compared the efficacy of 9.5-Gy and 10-Gy single-fraction electron beam radiation therapy after surgical excision and evaluated the impact of radiation timing on outcomes. MATERIALS AND METHODS This study was conducted on patients with ear keloid who underwent surgical excision and postoperative electron beam radiotherapy between May 2021 and June 2024. Patients were divided into groups based on radiation dose (9.5 vs 10) and timing (within 8 hours vs 24 hours postoperatively). Recurrence rates and complications were also compared. RESULTS The study included 182 patients (21 men and 161 women). The overall recurrence rate was 3.3% (6/182). The 10-Gy group had a significantly lower recurrence rate than the 9.5-Gy group (0.81% vs 8.47%; p = .014). Radiation timing did not significantly influence recurrence rates (2.59% vs 3.80%, p = 1). Complications were not significantly different. CONCLUSION A postoperative single dose of 10 Gy is the most effective low-dose single fractional electron beam radiotherapy for preventing ear keloid recurrence. Once administered within 24 hours after surgery, the timing of radiotherapy has no significant impact on treatment outcomes.

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Outcomes of omega variant keystone flap in conjunction with single fraction radiotherapy for helical keloids: A comprehensive one-year follow-up study

Cited by 3 publications

References 19 publications

How to Safely Use the Perforator-based Keystone Island Flap in the Scalp: Basal Cell Carcinoma of the Scalp With Local Invasion to Calvarium

How to Safely Use the Perforator-based Keystone Island Flap in the Scalp: Basal Cell Carcinoma of the Scalp With Local Invasion to Calvarium

Efficacy of Immediate Postoperative Single Fractional 10 Gy Radiotherapy for Earlobe Keloids

A Comparative Analysis of Postoperative Single Fraction of 9.5 Gy Versus 10 Gy for Ear Keloids

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