摘要

Objectives: To evaluate the efficacy of a combined ablative and non-ablative fractional laser protocol with trans-epidermal corticosteroid delivery in reducing recurrence rates of ear keloids following surgical excision. Introduction: Ear keloids have a high recurrence rate after surgical excision, often exceeding 50%. This presents a persistent clinical challenge. Laser-assisted drug delivery (LADD) after surgical excision of the keloid could improve therapeutic outcomes. This adjunctive approach may help reduce fibroproliferative activity and improve treatment results. Materials / method: This prospective study enrolled 40 patients with primary or recurrent ear keloids. Keloids were surgically excised. 10 to 14 days post patients initiated a series of four laser sessions, at four week intervals. A hybrid laser of CO2 and 1570nm was used, immediately followed by trans-epidermal delivery of triamcinolone acetonide. In cases with clinical signs of recurrence, 1–3 additional treatments were performed. Patients were followed for six months post-final treatment. ’ Treatment effectiveness was measured by clinical recurrence rate, photographic documentation, and patient satisfaction. Results: Out of the 40 patients treated, fewer than 20% experienced clinical recurrence during follow-up, showing a significantly lower rate compared to historical controls and standard monotherapy methods. Most patients reported high satisfaction with both aesthetic and symptomatic improvements. The treatment was well tolerated, with no severe adverse events reported. Conclusion: This combined protocol - surgical excision followed by fractional ablative and non-ablative laser treatments with trans-epidermal steroid delivery demonstrates a promising approach to reduce keloid recurrence on the ear. The observed recurrence rate of <20% suggests improved efficacy over conventional methods, supporting the role of multimodal laser-based protocols in keloid management.