|LETTER TO EDITOR
|Year : 2012 | Volume
| Issue : 3 | Page : 161
Innovative pressure clip for ear keloid
Renuka P Desai1, Ananta A Kulkarni2, Suhas V Abhyankar2, Rohit R Singh3, Santosh H Bhatia2
1 Department of Occupational Therapy, All India Institute of Physical Medicine and Rehabilitation, Mumbai, India
2 Department of Plastic Surgery, Dr. D. Y. Patil Hospital and Research Centre, Navi Mumbai, India
3 Department of Surgery, KEM Hospital and Seth GS Medical College, Mumbai, India
|Date of Web Publication||12-Nov-2012|
Ananta A Kulkarni
Department of Plastic Surgery, Padmashree Dr. D Y Patil Hospital and Research Centre, Sector 5, Nerul, Navi Mumbai, Maharasthra 400706
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Desai RP, Kulkarni AA, Abhyankar SV, Singh RR, Bhatia SH. Innovative pressure clip for ear keloid. Indian J Otol 2012;18:161
Pressure therapy for prevention and treatment of ear keloid is a known method. Herein, we describe an innovative pressure clip for an ear keloid which is simple to make, cheap, easily available and very effective.
Keloids may occur in any location particularly after trauma or infection but are seen most commonly on the ear and over bony prominences such as sternum and mandible. Several treatment options exist for minimizing bulk and recurrence e.g. pressure garment, splinting, radiation, injection of steroid, silicone gel, intralesional excision, cryotherapy, 5 FU injection, bleomycininjection, interferon etc.
A combination of these therapies is most effective, but recurrences are common despite therapy.  The earlier the keloids are treated, the more likely they will respond.
A variety of splints have been described to give pressure to ear keloid (lobule, helical rim) for prevention and treatment e.g. Zimmer splint,  Silicone mould  and oyster splint. 
Herein, we describe a pressure clip made from a simple household cloth clip which is readily available, easy to use, and very cheap.
Materials required: A cloth clip, wooden or plastic, with plier tipped nose, orfit and silicone gel sheet.
Measurement of the keloid surface is taken and according to that size, 2 pieces of orfit are taken to fix on both inner sides of the clip.
The orfit is then dipped in warm water to make it soft and mould it around the tip of the clip. Once dried, the clip is placed to apply pressure on the keloid. If the pressure is more, the patient will complain of numbness, redness and pain. Immediately then, remoulding of the orfit can be easily done to minimize the pressure by increasing the surface area of the orfit, or using a clip with lesser tension. If the pressure is less, then it can be increased by applying a rubber band beside the spring or by decreasing the surface area of the orfit. We also advise the patient to use a piece of silicone sheet inside the clip. We have used this clip for three patients till now with good results. The total cost of this clip is around Rs 60 only.
In this way, we can use a simple, cheap and effective pressure clip for ear keloid.
| References|| |
|1.||Studdiford J, Stonehouse A, Altshuler M, Rinzler E. The management of keloids: Hands-on versus hands-off. J Am Board Fam Med 2008;21:149-52. |
|2.||Russell R, Horlock N, Gault D. Zimmer splintage: A simple effective treatment for keloids following ear-piercing. Br J Plast Surg 2001;54:509-10. |
|3.||Sand M, Sand D, Boorboor P, Mann B, Altmeyer P, Hoffmann K, et al. Combination of surgical excision and custom designed silicon pressure splint therapy for keloids on the helical rim. Head Face Med 2007;3:14. |
|4.||Hassel JC, Roberg B, Kreuter A, Voigtländer V, Rammelsberg P, Hassel AJ. Treatment of ear keloids by compression, using a modified oyster-splint technique. Dermatol Surg 2007;33:208-12. |