Full-thickness skin grafting with marginal deepithelialization of the defect for reconstruction of helical rim keloids

Excising a keloid from the helical rim generally results in a narrow defect with exposed cartilage. Skin grafting is a surgical method with a lowest recurrence rate for keloid treatment. Full-thickness skin grafting may produce an excellent cosmetic outcome, but is generally considered too unreliable over a poorly vascularized defect with exposed cartilage. Adding a new healthy bed with rich vascularity on the periphery will increase the probability of the entire graft surviving via the bridging phenomenon. We report full-thickness skin grafting using a marginal deepithelialization technique for treatment of helical rim keloids. After keloid excision, the surrounding normal skin was deepithelialized 2 to 3 mm wide over the defect border, followed by full-thickness skin grafting. All grafts survived completely. None of the keloids recurred, and they all showed an excellent aesthetic result during the follow-up period from 9 months to 6 years.