Recurrent Keloids: Risk Factors and Treatment Efficacy

BACKGROUND: The protocols for managing recurrent keloids remain contentious. This retrospective study analyzed both recurrent and new keloids to identify risk factors for recurrence and to evaluate various treatment strategies for recurrent keloids. METHODS: Patients were enrolled from July 2021 to January 2024 at the Plastic Surgery Department of Tianjin Hospital. Follow-ups were scheduled at 1, 3, and 6 months and 1 year posttreatment. The Patient and Observer Scar Assessment Scale, recurrence rate, and complications were used to evaluate therapeutic efficacy. RESULTS: A total of 85 patients with 98 keloids were enrolled, with 26 patients (30.59%) experiencing recurrent keloids. Univariate analysis identified several risk factors for recurrence, yet multivariable analysis revealed that keloids located on the thorax were significantly associated with an increased risk of recurrence. Patient and Observer Scar Assessment Scale scores showed no significant differences among various treatment subgroups at 3- and 6-month follow-ups. The injection with radiotherapy subgroup had a significantly higher recurrence rate than the other subgroups. CONCLUSION: Keloids located on the thorax should be closely monitored and actively treated. Comprehensive surgical excision combined with radiotherapy is recommended for managing recurrent keloids because it has been demonstrated to be a safe and efficacious method.