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19-01-2012 | Surgery | Article

Pressure device helps prevent recurrence of auricular keloid scarring


Free abstract

MedWire News: Regularly wearing an auricular pressure device overnight may reduce the chance of keloid scar recurrence, suggest results from a small exploratory study.

An effective single therapy for keloids - raised, "tumor-like" scars occurring from indefinite growth of modified fibroblast cells - has yet to be found.

Various treatments are used in combination to try and prevent recurrence, with the most common of these being surgical excision followed by corticosteroid injection. However, recurrence rates with this treatment combination can be as high as 50%. Pressure application has also been used to prevent recurrence, but many available devices do not fulfill optimum requirements, say researchers.

To try and combat the inadequacies of some of the available devices, Gregor Bran (University of Heidelberg, Mannheim, Germany) and colleagues developed and tested an auricular pressure device in seven patients, aged 22.6 years on average, who had auricular keloids treated with surgical excision and corticosteroid injection. The cause of the keloids in these patients was surgery or ear piercing.

The device is made of acrylate and made using a mold of each patient's ear. It adheres to the recommended guidelines for such devices, namely, it has high-tensile strength, is lightweight, aesthetically acceptable, easy and cheap to make, noninflammable, precise without compromising hearing, comfortable to wear, easy to apply and remove, hygienic, provides uniform pressure, and allows continuous perfusion control to prevent pressure sores.

The participants wore the device for 5 nights per week for a mean period of 24 months. No cases of pruritus, pain, or dysesthesia occurred during this time and none of the patients discontinued the study. No recurrences of keloid scarring were observed during the follow-up period.

The team concedes that it is difficult to accurately clinically evaluate this device with such a small number of patients, but they note that this particular diagnosis was rare at their center.

"Ongoing investigation to increase biomolecular understanding will result in the development of new, more effective therapies [for keloid]," write the authors in the Archives of Facial Plastic Surgery.

"Until then we have to continue our quest for the establishment of the most conclusive regimen, which combines minimal risks for the patient with high therapeutic success rates and a perspective of prophylaxis once treatment is finished."

By Helen Albert

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