The role of full-thickness skin grafting and steroid injection in the treatment of auricular keloids.

Keloids are a response to wound healing that occurs due to hyperproliferation of dermal collagen in response to skin injury (Olabanji et al, Surg Pract. 2005;9:2-7). Multiple modalities have been described in the literature to target these lesions, but treatment and prevention remain a challenge because of the high rate of recurrence (Brissett and Sherris, Facial Plast Surg. 2001;17:263-272; Kelly, Dermatol Ther. 2004;17:212-218; Robles and Berg, Clin Dermatol. 2007;25:26-32; Porter, Otolaryngol Clin North Am. 2002;35:207-220, viii). We studied the rate of recurrence of auricular keloids through a technique previously described in the literature (Converse and Stallings, Plast Reconstr Surg. 1972;49:461-463), but over a series of patients. Keloids were treated with total excision in combination with coverage of the resulting defect with a full-thickness skin graft and intradermal injection of triamcinolone acetonide solution at the periphery of the donor and recipient sites. From April 2006 to February 2007, 10 patients with auricular keloids were done using this technique, and during an 11-month follow-up no recurrence was observed. These results support that full-thickness skin grafts can be used to address keloid lesions without recurrence.