Aesthetic plastic surgery · 2026
Analysis of Risk Factors and Exploration of Treatment for Infected Keloid.
СтатьяНазвание и аннотация: Перевод в очереди
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Wang Yonglei, Wei Yin, Liu Shuting, Sun Songwei, Yao Donggang
Аннотация
OBJECTIVE: To identify independent risk factors for keloid infection and explore optimal therapeutic strategies for infected keloids.
METHODS: A retrospective study included 131 keloid patients (26 infected, 105 non-infected) from two hospitals (July 2021-January 2025). Univariate and multivariate logistic regression analyses screened infection-related risk factors. Efficacy was compared among infected patients treated with complete surgical excision + radiotherapy (n= 12), intralesional injection + radiotherapy (n= 10), and local resection of infectious focus + injection + radiotherapy (n= 4). Outcomes included Patient and Observer Scar Assessment Scale (POSAS), infection recurrence, keloid recurrence, and complications.
RESULTS: Multivariate logistic regression analysis identified maximum lesion diameter, disease duration and family history of keloids as independent risk factors for keloid infection (all P< 0.05). For infected keloids, the injection group had significantly higher 6-month/12-month POSAS scores, infection recurrence rate (50.0% vs. 0.0%), and keloid recurrence rate (60.0% vs. 16.7%) than the surgery group (all P< 0.05), with all infection recurrences accompanied by keloid recurrence. The local resection group showed 0% infection recurrence and 50.0% keloid recurrence, with no severe complications.
CONCLUSION: Keloid patients with large lesions, long disease duration, or positive family history are at high infection risk and require active monitoring. For infected keloids, complete surgical excision + adjuvant radiotherapy is preferred after inflammation control, offering superior long-term efficacy and low recurrence. Local resection + injection + radiotherapy is a feasible alternative for large/inoperable lesions but demands long-term follow-up due to relatively high keloid recurrence.
LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: A retrospective study included 131 keloid patients (26 infected, 105 non-infected) from two hospitals (July 2021-January 2025). Univariate and multivariate logistic regression analyses screened infection-related risk factors. Efficacy was compared among infected patients treated with complete surgical excision + radiotherapy (n= 12), intralesional injection + radiotherapy (n= 10), and local resection of infectious focus + injection + radiotherapy (n= 4). Outcomes included Patient and Observer Scar Assessment Scale (POSAS), infection recurrence, keloid recurrence, and complications.
RESULTS: Multivariate logistic regression analysis identified maximum lesion diameter, disease duration and family history of keloids as independent risk factors for keloid infection (all P< 0.05). For infected keloids, the injection group had significantly higher 6-month/12-month POSAS scores, infection recurrence rate (50.0% vs. 0.0%), and keloid recurrence rate (60.0% vs. 16.7%) than the surgery group (all P< 0.05), with all infection recurrences accompanied by keloid recurrence. The local resection group showed 0% infection recurrence and 50.0% keloid recurrence, with no severe complications.
CONCLUSION: Keloid patients with large lesions, long disease duration, or positive family history are at high infection risk and require active monitoring. For infected keloids, complete surgical excision + adjuvant radiotherapy is preferred after inflammation control, offering superior long-term efficacy and low recurrence. Local resection + injection + radiotherapy is a feasible alternative for large/inoperable lesions but demands long-term follow-up due to relatively high keloid recurrence.
LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .