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The Use of Silicone Adhesives for Scar Reduction.

ABSTRACT: Significance: This article discusses the history and developments of silicone gel sheeting (SGS) scar therapy. Furthermore, we review a breadth of literature to gain an insight into how and why topical silicone gels remain the favored treatment of medical experts in scar management. We also analyze an ever increasing number of alternative therapies claiming to provide enhanced scar reduction performance. Recent Advances: Topical silicone gel treatments seem to remain the first point of clinical recommendation in scar management. SGS has been used in scar therapy for over 30 years, during which its efficacy has been the subject of numerous clinical evaluations. Critical Issues: While the exact mechanisms by which SGS improves hypertrophic scars, keloid development and recovery are yet to be fully agreed upon, its ability to do so remains largely undisputed at present. However, there still is ongoing deliberation over the exact mechanism of action of silicone in improving a scar. At present it is likely that through occlusion of the scar site and hydration of the wound bed, the overactivity of scar-related cells is suppressed, and their activity normalized. Future Direction: The clinical support of topical silicone gel products, relative to all alternative scar therapies, is considered the internationally recommended first-line form of scar management, and favored by consensus among healthcare professionals. However, there still remains the need for further clinical evidence and a better understanding of the mechanism behind the benefit of silicone gel for use in the prevention of abnormal scarring.

SUBMITTER: Bleasdale B

PROVIDER: S-EPMC4486716 | biostudies-other | 2015 Jul

REPOSITORIES: biostudies-other

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Project description:IntroductionWounding affects the integrity of the skin and can ultimately result in skin scarring. Current therapeutic goals of wound treatment focus on the reduction of scar formation and severity. However, scar formation itself varies not only between individuals based on factors such as ethnicity, but also within an individual based on the location of the wound. Therefore, the preparation of customized treatments for individual patients represents an important therapeutic goal in the fields of dermatology and wound healing. The objective of this study was to evaluate the usefulness of fatty acids found in pracaxi oil in a compounded topical anhydrous silicone base for wound and scar therapy.MethodsInitially, 21 patients with various surgical, traumatic, or burn wounds and scars were enrolled into this case series. Patients applied a compounded topical anhydrous silicone base containing pracaxi oil with or without additional active ingredients, including pentoxifylline, caffeine, tranilast, and mupirocin. Wound/scar photographs taken before and after application of the compounded pracaxi oil topical formulation (with/without additional ingredients) were reviewed and adjudicated by a blinded dermatology reviewer. Improvements in wound size, coloration, and overall appearance before and after treatment were determined. Patient satisfaction was assessed after application of compounded topical formulation using a self-report questionnaire distributed at the time of dispensing.ResultsA total of seven patients were considered available for analysis and were included in the study. In all seven cases, patients reported improvement in scar and wound attributes, including scar and wound size, severity, color, and pain associated with the scar or wound after application of the compounded medicine. On average, patients rated their satisfaction with treatment highly, with a mean score of 10 on a rating scale of 1-10. Retrospective review of wound/scar photographs demonstrated clinically relevant improvements in wound attributes as assessed by a dermatologist. Six of the seven wounds examined were considered "much improved" from baseline.ConclusionsApplication of a compounded anhydrous silicone base containing pracaxi oil alone or in combination with other active substances led to considerable improvements in wound healing and scar attributes and is a potentially useful option in the treatment of surgical, traumatic, or burn wounds and scars.

Project description:BackgroundScar assessment plays a key role during burns aftercare, to monitor scar remodelling and patients' psychosocial well-being. To aid assessment, subjective scar assessment scales are available that use health-care professionals' and patients' opinions to score scar characteristics. The subjective scales are more widely used in clinical practice over objective scar measures. To date, there is no research that considers patients' views on scar assessment and the role of subjective and objective assessment tools. Therefore, the aim of this qualitative study was to explore patients' perspectives on scar assessment and the utility of scar assessment tools during burns rehabilitation.MethodsSemi-structured interviews were conducted with 10 adult burn patients who were being reviewed in clinic for scarring. Participants were recruited via their clinical care team and research nurses at the Queen Elizabeth Hospital, Birmingham, UK. Topics covered during interview included patient experience of scar assessment, the use of scar assessment tools and discussion surrounding important factors to be addressed when assessing scars. A thematic analysis using the Framework Method was conducted.ResultsParticipants identified key subthemes that contribute towards the overarching theme of patient-centred scar assessment. These are: patient-led care; continuity in care; learning how to self-manage scarring; and psychological assessment. Links were demonstrated between these subthemes and the remaining themes that describe scar assessment strategies, indicating their potential patient-centred contributions. The subjective opinions of clinicians were found to be valued above the use of subjective or objective scar assessment tools. Scar assessment scales were perceived to be a beneficial method for self-reflection in relation to psychosocial functioning. However, minimal feedback and review of completed assessment scales led to uncertainty regarding their purpose. Patients perceived objective tools to be of primary use for health-care professionals, though the measures may aid patients' understanding of scar properties.ConclusionsScar assessment tools should be used to support, rather than replace, health-care professionals' subjective judgements of scarring. Adapting the way in which clinicians introduce and use scar assessment tools, according to patient needs, can support a patient-centred approach to scar assessment.

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The Use of Silicone Adhesives for Scar Reduction.

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