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

OBJECTIVE To examine the application of silicone gel sheets on linear scars due to surgical procedures. METHOD 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). RESULTS 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. CONCLUSION 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.

[1]  R. Ogawa,et al.  The tensile reduction effects of silicone gel sheeting. , 2010, Plastic and reconstructive surgery.

[2]  C. Li-Tsang,et al.  A Randomized Clinical Trial to Study the Effect of Silicone Gel Dressing and Pressure Therapy on Posttraumatic Hypertrophic Scars , 2010, Journal of burn care & research : official publication of the American Burn Association.

[3]  Thomas A. Mustoe, MD, FACS,et al.  Occlusion regulates epidermal cytokine production and inhibits scar formation , 2010, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[4]  D. Cassuto,et al.  Treatment of hypertrophic scars and keloids with an LBO laser (532 nm) and silicone gel sheeting , 2010, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[5]  Thomas A. Mustoe, MD, FACS,et al.  Homeostasis of the epidermal barrier layer: A theory of how occlusion reduces hypertrophic scarring , 2009, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[6]  P. Durani,et al.  The Patient Scar Assessment Questionnaire: A Reliable and Valid Patient-Reported Outcomes Measure for Linear Scars , 2009, Plastic and reconstructive surgery.

[7]  O. Goldan,et al.  Patient and observer scar assessment scale: how good is it? , 2009, Journal of wound care.

[8]  F. Franchignoni,et al.  How to assess postsurgical scars: A review of outcome measures , 2009, Disability and rehabilitation.

[9]  Thomas A. Mustoe, MD, FACS,et al.  The role of the epidermis in the control of scarring: evidence for mechanism of action for silicone gel. , 2008, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[10]  C. Castagnoli,et al.  Postburn Scars: An Update , 2008, The international journal of lower extremity wounds.

[11]  L. Seress,et al.  Morphological Analysis of the Connective Tissue Reaction in Linear Hypertrophic Scars Treated with Intralesional Steroid or Silicone-Gel Sheeting. A Light and Electron Microscopic Study , 2008, Acta biologica Hungarica.

[12]  I. Olivotto,et al.  Reliability and Validity Testing of the Patient and Observer Scar Assessment Scale in Evaluating Linear Scars after Breast Cancer Surgery , 2007, Plastic and reconstructive surgery.

[13]  D. Kriegel,et al.  Topical treatments for hypertrophic scars. , 2006, Journal of the American Academy of Dermatology.

[14]  C. Li-Tsang,et al.  A prospective randomized clinical trial to investigate the effect of silicone gel sheeting (Cica-Care) on post-traumatic hypertrophic scar among the Chinese population. , 2006, Burns : journal of the International Society for Burn Injuries.

[15]  Claire D. Johnson.  Measuring Pain. Visual Analog Scale Versus Numeric Pain Scale: What is the Difference? , 2005, Journal of chiropractic medicine.

[16]  P. V. van Zuijlen,et al.  Reliable and Feasible Evaluation of Linear Scars by the Patient and Observer Scar Assessment Scale , 2005, Plastic and reconstructive surgery.

[17]  D. Chang,et al.  Topical scar modification: hype or help? , 2005, Aesthetic surgery journal.

[18]  F. Wood,et al.  [International clinical recommendations on scar management]. , 2002, Zentralblatt fur Chirurgie.

[19]  R. Cartotto,et al.  Effects of enhanced patient education on compliance with silicone gel sheeting and burn scar outcome: a randomized prospective study. , 2003, The Journal of burn care & rehabilitation.

[20]  Edward C. Jones,et al.  A comparison of two time intervals for test-retest reliability of health status instruments. , 2003, Journal of clinical epidemiology.

[21]  L. Borgognoni.  Biological effects of silicone gel sheeting , 2002, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[22]  J. Fish,et al.  The effect of silicone gel sheets on perfusion of hypertrophic burn scars. , 2001, The Journal of burn care & rehabilitation.

[23]  C. Maher,et al.  Responsiveness of visual analogue and McGill pain scale measures. , 2001, Journal of manipulative and physiological therapeutics.

[24]  J. Sim,et al.  Validity, reliability and responsiveness in the assessment of pain , 1997 .

[25]  L. Perry,et al.  Evaluation of Silicone‐Gel Sheeting on Early Wound Healing of Linear Incisions , 1995, Annals of plastic surgery.

[26]  M. Gold,et al.  A controlled clinical trial of topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. , 1994, Journal of the American Academy of Dermatology.

[27]  Donald D. Price,et al.  A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales , 1994, Pain.

[28]  S. Harkins,et al.  Sensory-affective relationships among different types of clinical and experimental pain , 1987, Pain.

[29]  D. Price,et al.  The validation of visual analogue scales as ratio scale measures for chronic and experimental pain , 1983, Pain.