en تخصصي Special مقالات اصيل Original Article <div> <p><strong>BACKGROUND</strong><br> Keloids as unusual scars are injury remnants characterized by bizarre cosmetics and painful itching. This study assessed outcomes of surgical excision and brachytherapy in intractable keloids.<br> <strong>METHODS</strong><br> Six patients with 10 keloid lesions were followed up. Surgical excision was done with 1-2 mm margin, and then radiotherapy was undertaken in 3 divided fractions on days 0, 1 and 2 after surgery. Scar improvement was evaluated by patients and observer with scar assessment scale (POSAS)<br> <strong>RESULTS</strong><br> Median age of patients was 38.3&plusmn;6.4, while 40% were male and 60% were female. The mean primary size of the lesion before brachytherapy was 325.18&plusmn;426.16 mm² and the median size was 153.48 mm². The mean primary size of the lesions with recurrence before brachytherapy was 150.50&plusmn;124.78 mm². The clinical improvement of the scars with POSAS scoring by the observer was 17.1&plusmn;3.2 and by the patients was 20.8&plusmn;11.5. In 5 patients who were evaluated, two keloid lesions showed recurrence (20%), and 8 lesions had no recurrence (80%). No patients reported side effects, but only one patient, a 43 years old woman with 5 keloid lesions, suffered wound infection and local dehiscence of the wound, followed by the second session of brachytherapy. The average time of relapse was 26.3&plusmn;0.9 months.<br> <strong>CONCLUSION</strong><br> The use of surgical resection in combination with brachytherapy was demonstrated as a modality for treatment of refractory keloid scars that can be recommended to surgeons who deal with these patients.</p> </div> Brachytherapy, Excision, Surgery, Keloids 280 284 http://wjps.ir/browse.php?a_code=A-10-200-1&slc_lang=en&sid=1 Ahmadreza Taheri drtaheri1@gmail.com 10031947532846004249 10031947532846004249 No Plastic and Reconstructive Surgery Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Hojjat Molaei hojjat_9@hotmail.com 10031947532846004250 10031947532846004250 Yes Plastic and Reconstructive Surgery Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mehdi Aghili 10031947532846004251 10031947532846004251 No Oncology and Radiotherapy Department, School of Medicine, Tehran University of Medical Sciences, Tehran Iran Naser Rahmanpanah 10031947532846004252 10031947532846004252 No Plastic and Reconstructive Surgery Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Atefeh Mirmohseni atefehmirmohseni@gmail.com 10031947532846004253 10031947532846004253 No Plastic and Reconstructive Surgery Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran