Use of Retroauricular Flaps to Reconstruct Defects of the Helical Rim and Adjuvant Intralesional Corticosteroids after Resection of Large Keloids.

BACKGROUND: The optimal treatment for large helical rim keloids remains unclear. AIMS: The authors evaluated patient outcomes when retro auricular flaps were used to reconstruct helical rim defects and adjuvant intralesional corticosteroids were prescribed after resection of large keloids. MATERIALS AND METHODS: The authors evaluated 7 females with 12 large keloids of the helical rim (5 patients had lesions in both ears). All patients were aged 18 to 33 years. The authors used retro auricular flaps to reconstruct the helical rim defects and prescribed adjuvant intralesional corticosteroids after resection. The lesion area ranged from 2.5 × 2.0 to 3.5 × 3.5 cm2. The flap size ranged from 2.5 × 3.0 to 3.5 × 4.5 cm2. The flaps and wound bases received 3 steroid injections at approximately 1, 2, and 3 months postoperatively. RESULTS: No flap necrosis or complications were noted. The postoperative esthetic results were satisfactory in 8 patients and excellent in 4. All patients were followed up for 14 to 28 months (median, 20.6 months). No recurrence was noted, although 3 patients exhibited mild scarring of the wound flap base. CONCLUSIONS: A retro auricular flap is safe and effective for reconstructing helical rim defects; adjuvant intralesional corticosteroids prevent scarring of the flap wound base after resection of large keloids.