Abstract
Keloids are cosmetically, psychologically and functionally debilitating wounds that have proven difficult to treat with surgical excision alone. Large keloids are particularly challenging to treat because many of the current therapies for keloids are unsuitable, and the remaining defect after excision is difficult to close. The authors report a case involving a large disfiguring keloid on the head and neck, which was treated with surgical excision and immediate reconstruction with a free anterolateral thigh fasciocutaneous flap. No further adjuvant therapy was undertaken. At one-year follow-up, there was no recurrence at the recipient site, and the donor site healed without deformity. The free fasciocutaneous anterolateral thigh flap may be effective at treating large keloids in the head and neck region; however, well-controlled clinical studies are needed to establish this.