Does postoperative radiation within 24 hours of a skin graft with a keloid resection increase the risk of graft failure?

The amount of radiation required to prevent keloid recurrence after excision is lower than what would be expected to compromise a skin graft. The studies cited are dealing with postoperative radiotherapy for cancer, where radiation doses are required to be higher than what is used for a keloid, and as a result, the risk of graft loss is higher. For this reason, waiting a few weeks for healing is necessary. This is probably not necessary for postoperative keloid treatment.

I am not aware of any data looking at this question. However, extrapolating from several papers on the subject of the recommended timing for post-op RT after skin grafting for excision of NMSCs, I agree with Dr. Mendenhall that I suspect that post-op RT within 24 hours would likely result in higher graft failure (than waiting 4+ weeks).

Based on a response in another MedNet thread (https://www.themednet.org/question/1644), Dr. Bogardus recommends waiting anywhere from 4 weeks up to 10 weeks post-skin grafting to begin post-op RT (in order to wait for the skin graft to clinically appear completely healed without sinus tracts or infection).

In addition, based on a review of a publication examining (split-thickness) skin graft tolerance to pos...

I don’t know, but I suspect yes.