Scientific References
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The Biological Effects of Silicone Gel Sheeting.pdf (4pgs. 300kb)
From the Division of Plastic and Reconstructive Surgery, St. M. Annunaiata Hospital, Florence, Italy.
Aesthetic Plast Surg. 2008 Jan;32(1):82-92. Epub 2007 Oct 30.
Evolution of silicone therapy and mechanism
of action in scar management.
Mustoe TA.
Division of Plastic Surgery, Northwestern University School of
Medicine, 675 North Street Clair 19-250, Chicago, IL 60611, USA.
tmustoe@nmh.org
Silicone-based products are widely used in the management of hypertrophic
scarring and keloids. This review discusses the range of products
available and the clinical evidence of their efficacy in preventing
excessive scarring and improving established scars. Silicone gel
sheeting has been used successfully for more than 20 years in scar
management. A new formulation of silicone gel applied from a tube
forms a thin flexible sheet over the newly epithelialized wound
or more mature scar. Results from clinical trials and clinical
experience suggest that silicone gel is equivalent in efficacy
to traditional silicone gel sheeting but easier to use. The mechanism
of action of silicone therapy has not been completely determined
but is likely to involve occlusion and hydration of the stratum
corneum with subsequent cytokine-mediated signaling from keratinocytes
to dermal fibroblasts.
J Am Acad Dermatol. 2006 Dec;55(6):1024-31. Epub 2006 Sep 18.
Topical treatments for hypertrophic scars.
Zurada JM, Kriegel D, Davis IC.
Columbia University College of Physicians and Surgeons, New York,
New York, USA.
Hypertrophic scars represent an abnormal, exaggerated healing response
after skin injury. In addition to cosmetic concern, scars may cause
pain, pruritus, contractures, and other functional impairments.
Therapeutic modalities include topical medications, intralesional
corticosteroids, laser therapy, and cryosurgery. Topical therapies,
in particular, have become increasingly popular because of their
ease of use, comfort, noninvasiveness, and relatively low cost.
This review will discuss the properties and effectiveness of these
agents, including pressure therapy, silicone gel sheeting and ointment,
polyurethane dressing, onion extract, imiquimod 5% cream, and vitamins
A and E in the prevention and treatment of hypertrophic scars.
PMID: 17097399 [PubMed - indexed for MEDLINE]
1: Ann Ital Chir. 2005 Jan-Feb;76(1):79-83.
[Silicone occlusive sheeting vs silicone cushion for the treatment
of hypertrophic and keloid scars. A prospective-randomized study]
[Article in Italian]
Amicucci G, Schietroma M, Rossi M, Mazzotta C.
Dipartimento di Scienze Chirurgiche Università degli Studi
di L'Aquila.
BACKGROUND: Silicone gel and silicone occlusive sheeting are widely
used at present for the treatment of hypertrophic and keloid scars.
In recent studies the possibility was raised that static electricity
generated by friction activated silicone sheeting could be the
reason for this effect, and that it can, with time, cause involution
of hypertrophic and keloid scars. Objective of this study was to
test this hypothesis and to observe weather a continuous and also
an increased negatively charged static electric field will shorten
the treatment period. A silicone cushion was developed with the
purpose of increasing a negative static-electric charge to accelerate
the regression process. METHODS: From November 2001 to June 2002
we studied in a prospective randomized study, 72 patients with
hypertrophic an keloid scars. The trial extended over a 8-month
period. 37 patients underwent silicone occlusive sheeting, the
remaining 35 patients underwent silicone cushion (Clinicel). RESULTS:
Treatment with the silicone cushions yielded 74,2% cessation of
itching and burning followed by pallor and flattening of the scar,
some markedly so, over a few weeks to 5 months period. Additional
25,7% had their scars resolved in up to 8 months of treatment.
Four patients (11,4%) who add recalcitrant scars with little response
to the use of the silicone cushion were given intralesional corticosteroid
injections, in addiction to the use of the cushion, resulting in
a fairly rayed resolution of these scars over a period of 2 months.
Treatment with the silicone occlusive sheeting yielded 52,3% itching
and burning cessation followed by pallor and flattening of the
scar, some markedly so, over a few weeks to 5 months period. Additional
22,1% had their scars resolved in up to 8 months of treatment.
In conclusion by comparing the results of this trial using silicone
cushions for the treatment of hypertrophic and keloid scars with
those obtained using silicone gel or occlusive sheeting, a much
faster response was demonstrated.
1: Plast Surg Nurs. 2006 Apr-Jun;26(2):87-92.
Influence of silicone on abnormal scarring.
Fette A.
Wound Healing and Tissue Repair from the WHRU, University of Cardiff,
Wales. andreas.fette@gmx.de
The problem of scarring represents a large area of an unmet medical
need, since people with abnormal skin scarring may face physical
and psychological consequences that may be associated with substantial
emotional and financial costs. To date, treatment options are to
leave the scar alone or use invasive or noninvasive management.
Silicone is the key in noninvasive management, with the following
overall results reported: great improvement of the scar appearance,
easy to apply, painless, and almost free of side effects. When
analyzing all presented results in this research sample, it becomes
obvious that they are mainly based on subjective, not well-defined
scar assessment by the individual without comparison to controls
or rating against validated scores and therefore lacking real scientific
or evidence-based criteria.
PMID: 16783182 [PubMed - indexed for MEDLINE]
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