Can patients receive adjuvant radiation therapy after keloid excision without primary closure, or would radiation impede healing by secondary intention?

I have personally treated several patients where primary closure was not obtained due to the large size of the keloid (back and anterior mid-chest). Due to the limitation of raising a large flap around these regions to close the wound primarily and poor take rates of a skin flap, these resections we...

I am not aware of any personal experience or experience at our institution in which post-op keloid excision site(s) were treated without first undergoing primary closure (i.e. not healing by secondary intention).

I am also not aware of any literature that looked at or included patients who underwent...

Institutionally, we have treated a number of patients with after debulking/shave/secondary intention resections. Usually with doses of 7 Gy x 3 fx with e- to a 90% IDL and some bolus. (6 Gy x 3 for earlobe, 3D planned with lead distal blocking). This has been an extrapolation of RT as per Flickinger...

I have employed radiotherapy for areas of the back, chest, and earlobe after shave removal of keloids for years with relatively good results. While the vast majority of my keloid cases are closed primarily, often converting a keloid into a long linear scar with side-to-side closure, flap, or graft r...