Linear scar reduction using silicone gel sheets in individuals with normal healing.
ABSTRACT Objective: To examine the application of silicone gel sheets on linear scars due to surgical procedures. Method: Ten individuals, with scars less than 1 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 (VAS). 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 scar sides) 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).
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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.01/2013; 2013:270953. DOI:10.1155/2013/270953
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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