Linear scar reduction using silicone gel sheets in individuals with normal healing
To examine the application of silicone gel sheets on linear scars due to surgical procedures.
Ten individuals, with scars less than I year old, participated in the study. The Participant and Observer Scar Assessment Scale (POSAS) was used to evaluate scars on seven characteristics rated by visual analogue scales 0fAS). Participants applied silicone gel sheets to half of their scar for 6 months, and every 2 weeks POSAS data forms were completed. Linear mixed-effects analysis of variances (ANOVA)were used to determine if significant differences occurred between groups (treated and untreated scarsides) across the 6 months of data collection. To see if differences were found from the initial evaluation to final visit, Mann-Whitney U tests analysed between-group changes (treated and untreated scar sides), while Wilcoxon signed ranks tests compared within-group changes (evaluation of each scar side over time).
No significant differences in VAS ratings were observed when the two scar sides were compared, with the exception of overall opinion of the scar, as rated by an observer. For each group,significant changes from baseline to study end were observed for colour, stiffness and irregularities, as rated by the participant. Significant improvements for the treated versus untreated group were observed for pliability and pigmentation, as rated by the observer scale.
There was no evidence for improved healing when using silicone gel sheets. The results do not support using silicone gel sheets on linear scars for individuals with no history of abnormal scarring.
Available from: Fabrizio Consorti
- "The primary endpoint was the appearance of wound at the 6th post-operative week assessed through a validated scar assessment scale, the Patient and Observer Scar Assessment Scale (POSAS) . POSAS was initially developed for burn scars, but it has been used and validated for several different types of wounds     . It is composed of two subscales, the Observer Scale (OSAS) and the Patient Scale (PSAS). "
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ABSTRACT: Objective. To compare the quality of resulting scar at 6 weeks after total thyroidectomy with the use of the tissue adhesive octyl-cyanoacrylate or subcuticular absorbable suture for the closure of cervicotomy. Material and Methods. There are 50 patients undergoing a cervicotomy for total thyroidectomy. Twenty-five patients were randomly assigned to closure with tissue adhesive and 25 with subcuticular absorbable suture. At week 6 the scar was evaluated by blinded assessors with the Italian version of POSAS questionnaire, a validated wound scale composed of an observer's and a patient's subscale. Results. Assessment of scar appearance showed a statistically significant difference (p = 0. 038) in favor of subcuticular suture with respect to tissue adhesive on observer's assessment. The difference on patients' self-assessment was not significant. A multivariate analysis of six qualitative features of scars showed a significant influence on assessment for hyperpigmentation and relief of scar. The Italian version of POSAS proved to be reliable. Conclusion. Though tissue adhesive represents a valid method of skin closure, subcuticular absorbable suture provides a better aesthetic outcome in small cervical incisions in the early phase after thyroid surgery.
11/2013; 2013:270953. DOI:10.1155/2013/270953
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ABSTRACT: Mechanically offloading or shielding an incision significantly reduces scarring in both animal and first-in-human studies. Whether or not this strategy would be effective following scar revision surgery was previously unknown. Here we report that the embrace™ device, which utilizes principles of mechanomodulation, significantly improves aesthetic outcomes following scar revision surgery.
A prospective, open label, randomized, single-center study was conducted to evaluate the appearance of scars following revision and embrace™ treatment. Revision surgery was performed on twelve patients, each acting as their own control, and outcomes were assessed at six months. The Visual Analog Scale (VAS) was used to evaluate each scar, rated by four independent surgeons who were not involved in the study.
Evaluation of six month scar images by four independent surgeons using the VAS scale demonstrated a highly significant improvement in scar appearance following embrace™ treatment (p < 0.005).
The embrace™ device represents a powerful new technology for significantly improving scar appearance following revision surgery.
Plastic and Reconstructive Surgery 10/2013; 133(2). DOI:10.1097/01.prs.0000436526.64046.d0 · 2.99 Impact Factor
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ABSTRACT: Scarring represents a significant biomedical burden in clinical medicine. Mechanomodulation has been linked to scarring through inflammation, but until now a systematic approach to attenuate mechanical force and reduce scarring has not been possible.
We conducted a twelve month, prospective, open label, randomized, multi-center clinical trial to evaluate abdominoplasty scar appearance following post-operative treatment with the embrace device to reduce mechanical forces on healing surgical incisions. Incisions from 65 healthy adult subjects were randomized to receive embrace treatment on one half of an abdominoplasty incision and control treatment (surgeon's optimal care methods) on the other half. The primary endpoint for this study was the difference between assessments of the scar appearance for the treated and control sides using the Visual Analogue Scale (VAS) scar score.
Final twelve month study photos were obtained from 36 subjects who completed at least five weeks of dressing application. The mean VAS score for embrace-treated scars (2.90) was significantly improved compared to control-treated scars (3.29) at 12 months (difference = 0.39, 95% confidence interval [0.14, 0.66], p = 0.027). Both subjects and investigators found that embrace-treated scars demonstrated significant improvements in overall appearance at 12 months using the Patient and Observer Scar Assessment Scale (POSAS) evaluation (p = 0.02 and p < 0.001, respectively). No serious adverse events were reported.
These results demonstrate that the embrace device significantly reduces scarring following abdominoplasty surgery. To our knowledge, this represents the first level one evidence for post-operative scar reduction.
Plastic and Reconstructive Surgery 05/2014; 134(3). DOI:10.1097/PRS.0000000000000417 · 2.99 Impact Factor
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