Retrospective analysis of keloid split-thickness skin graft replantation combined with LCR therapy for keloid treatment

Aim: To evaluate the clinical efficacy of scar split-thickness skin replantation combined with LCR (laser-carbon dioxide-radiotherapy) therapy in improving healing outcomes and reducing recurrence rates in patients with multiple nodular or hypertrophic keloid lesions. Methods: A retrospective review was conducted on 11 patients who underwent surgical excision of keloids, followed by replantation of split-thickness skin graft onto the thinned keloid dermis. Postoperatively, all patients received LCR therapy. Clinical outcomes were assessed using the Patient and Observer Scar Assessment Scale (POSAS) before and after treatment. Postoperative epithelialization time and adverse events were also recorded. Results: All patients achieved complete epithelialization within four weeks after surgery. Significant improvement in scar quality was observed, with POSAS scores decreasing from 92.35 ± 6.09 pre-treatment to 18.58 ± 7.38 post-treatment (P < 0.001). No severe complications such as infection or ulceration occurred during the follow-up period. Conclusion: Scar split-thickness skin replantation combined with LCR therapy is a safe, cost-effective, and efficacious treatment modality for keloids. By preserving the dermal scaffold and enhancing epithelial regeneration, this approach significantly improves scar appearance and reduces recurrence, particularly in challenging cases involving multiple or hypertrophic keloid nodules.