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Introduction Keloids may pose significant difficulty to affected patients: they can be painful, itchy, impact mobility if they cross joints, and most disruptively, can be physically disfiguring and cause emotional distress. While multiple treatments exist, none reliably provide scar resolution, and up to 100% of keloids return after surgical excision. MatriDerm is a dermal replacement scaffold that has shown previous efficacy in management of a variety of acute and chronic wounds in adults, including burns. In this two patient case series, we aim to demonstrate the efficacy of single-step application of MatriDerm dermal substitute with split-thickness skin grafting in the management of keloid scars caused by burns in the pediatric population. Methods Both patient A and B experienced a scald burn (patient A – suprapubic, patient B – right buttock) that initially healed with supportive care, but subsequently developed significant scarring refractory to initial laser therapy and Kenalog injection. They each underwent excision of keloid scar, application of dermal matrix (MatriDerm), and application of split-thickness skin graft. Patient A had a negative pressure wound therapy device applied to their surgical site, while patient B had application of a bolster. Both patients subsequently underwent two laser ablation procedures to reduce the risk of recurrent keloid formation. Patient A required additional post-operative Kenalog injection one month following MatriDerm application. Results Post-operative wounds of patient A and B demonstrate marked improvement in scar size, composition, and elevation. No re-excision of keloid or hypertrophic scar has been required. Post-operative pain was managed with over-the-counter analgesia as needed (acetaminophen, ibuprofen). No post-operative infections were reported. There were no inpatient re-admissions for post-operative complications.

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When and Where Presented

Presented at the 42nd Annual North American Burn Society Conference; Marcy 24-29, 2024; Olympic Valley, CA.

Single-step Collagen-elastin Dermal Matrix with Split-thickness Skin Grafting for Keloid Burn Scars: A Case Series

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Pediatrics Commons