Linear scar reduction using silicone gel sheets in individuals with normal healing

Journal of Wound Care (Impact Factor: 1.07). 12/2012; 21(12):602-9. DOI: 10.12968/jowc.2012.21.12.602
Source: PubMed


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.

28 Reads
  • Source
    • "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) [15]. POSAS was initially developed for burn scars, but it has been used and validated for several different types of wounds [17] [18] [19] [20] [21]. It is composed of two subscales, the Observer Scale (OSAS) and the Patient Scale (PSAS). "
    [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Measuring quality of life through questionnaires is a common method to evaluate the impact of different afflictions on the patient's well-being, especially in the field of dermatology where appearance changing afflictions are common.ObjectivesA variety of questionnaires has been used to distinguish different skin conditions like psoriasis, atopic dermatitis and scars. Using the Dermatology Life Quality Index (DLQI), we investigated different scar types regarding their impact on quality of life.Methods We assessed the quality of life in 130 patients presenting to our outpatient scar clinic for the first time using the DLQI. Scars were analysed according to their clinical appearance (physiological scars, keloids, hypertrophic scars, atrophic scars, self-harm scars). Physiological scars were established as a baseline for further comparison between groups.ResultsPatients in the physiological scar group scored a mean DLQI score of 2.07 ± 3.56, patients in the keloid-, hypertrophic scar-, atrophic scar- and self-harm scar group scored values of 6.06 ± 4.00, 2.53 ± 2.48, 7.26 ± 6.72 and 12.00 ± 3.85 respectively. When compared to the baseline group the difference in the overall score for keloids was +3.99 (P < 0.001), hypertrophic scars scored +0.45 (ns), atrophic scars +5.19 (P < 0.01) and self-harm scars +9.93 (P < 0.001).Conclusion Using the DLQI, we could demonstrate that different subsets of pathological scars do affect patients in a different magnitude. The DLQI provides a promising adjunct for quantifying the quality of life in patients suffering from keloids, atrophic- and self-harm scars and may constitute an interesting additional tool for monitoring the progress of scar treatments.
    Journal of the European Academy of Dermatology and Venereology 04/2015; DOI:10.1111/jdv.13135 · 2.83 Impact Factor
Show more