TREATMENT OF KELOID SCAR GENERAL SURGERY CASE BASED QUESTION
yeah happiness uh this is dr srikant from team mds conquer now we'll have a quick glance of this particular topic which is most commonly and frequently repeated in the exam so before going into the treatment i am just going to give three or four important points related to this particular scar for a case based question so the background history they may give related to this particular scar like it is most common in the woman or they may give ethiology of occurrence of one particular bacterial infection that is tuberculosis is one of the ethiology for occurrence of this keloid scar and it is most common in uh blacks that is negros it is most common in negros when compared to the regular population and it has claw-like process and the keloid is unslightly often tender to touch and always itches itching is one of the most common thing and of course uh in the case based question they can give you that excision followed by reoccurrence reoccurrence is very common commonly occurred in the keloid when compared to that of the hypertrophic scar like itching is there okay and reoccurrence is very familiar women tb theology so coming to the treatment so treatment we have lots of questions on treatment and most of you are confused about the treatment so according to ssdas the treatment options for the keloid were categorized into two types the type one is conservative and type two is surgical surgical problem is reoccurrence will be more than surgical so it's better treatment if they ask you the best treatment ideal treatment it is definitely the conservative treatment where you will go for intra relational injection of steroids okay so first of all coming to the conservative treatments so in conservative treatments we have the following options which you have to focus on first is the intralesional injection of steroids or you can try the introduction injection of hydrolysis which helps in lysising this collagen fibers or immature immature fibroblasts and all these things you can try uh intra-regional injection of vitamin a and methotrexate has also been tried but the best is the first one the next one deep x-ray therapy has also been tried a mode of radiotherapy okay with with some success rate so basically what happens here it it is going to suppress the proliferation of immature fibroblasts and blood vessels and thereby stops the growth of the keloid and it stops the itching also there are a few studies telling that itching is also being stopped by using deep x-ray therapy and ultrasonic therapy has also been tried okay so you can make a note about ultrasonic therapy also in the case of your conservative coming to the surgical excision and resuturing is most commonly uh done but uh recurrence rate is very very high so what they have done is they have added pre-operative and post-operative radiotherapy for a better result but it's not the best treatment sometimes because of the overgrowth class-like process and all these development so shaving away the excess scar tissue and resurfacing the tissue with thin skin graft has also been tried so these are the two sessions of keloid scar that you have to make your own there are high chances that they can ask you a case based question or interlinking a case based question with the best treatment plan among the list of the options okay i hope you are clear i am done with this small topic study well all the best signing of dr srikham from team mds concur
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