Keloid management remains controversial, and recurrence and untoward side effects limit the use of many techniques. During a seven-year period, I surgically treated 19 children, aged 3 to 17 (mean 10.5 years), with a total of 28 keloids. After aseptic skin preparation, the interface between the keloid and normal skin or subcutaneous tissue was injected with betamethasone sodium phosphate and betamethasone acetate suspension (Celestone Soluspan). The lesion was excised, and the defect was closed with subcutaneous polyglycolic acid suture. No further therapy was given. There has been no dermal or subcutaneous atrophy, and there have been no recurrences after an average follow-up of 35.5 months (six months to nine years). The technique is simple and successful, and avoids the painful postoperative series of injections often advocated.
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