Silicon gel sheeting for preventing and treating hypertrophic and keloid scars

O’Brien, Lisa

doi:10.1002/14651858.cd003826

Cited by 61 publications

(77 citation statements)

References 10 publications

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“…Since these early studies, 1,30,31 the subject of scar therapy has advanced dramatically along with clinical evidence, commercial engagement, and consumer interest. [32][33][34][35][36] This progression has been driven by the ongoing clinical support which continues to raise interest and awareness of the efficacy of SGS in scar management in comparison to the alternatives. 32,37,38 In fact, it is proposed that topical SGS and intralesional steroids are the only evidence-based recommendable forms of treatment to control the quality of a scar.…”

Section: Advantages Of Sgsmentioning

confidence: 99%

“…[32][33][34][35][36] This progression has been driven by the ongoing clinical support which continues to raise interest and awareness of the efficacy of SGS in scar management in comparison to the alternatives. 32,37,38 In fact, it is proposed that topical SGS and intralesional steroids are the only evidence-based recommendable forms of treatment to control the quality of a scar. 39 SGS not only prevails in terms of performance but in terms of its ease of use; its noninvasive application and relatively low cost give it a distinct practical advantage over the competition.…”

Section: Advantages Of Sgsmentioning

confidence: 99%

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The Use of Silicone Adhesives for Scar Reduction

Bleasdale¹,

Finnegan

Murray

et al. 2015

Advances in Wound Care

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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. SCOPE AND SIGNIFICANCESilicone gel sheeting (SGS) has been used in scar therapy for over 30 years, during which its efficacy has been the subject of numerous clinical evaluations. 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. As such, topical silicone gel treatments seem to remain the first point of clinical recommendation in scar management. This article aims to review a breadth of literature to gain an insight not only into how, but also 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 as a comparison. TRANSLATIONAL RELEVANCESilicone has been used for more than 30 years in the treatment of cutaneous scars.1 New formulations and formats of silicone gel products are becoming available for use in the treatment of scarring resulting from surgery, burns, and other skin injuries requiring hospital treatment.

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Section: Advantages Of Sgsmentioning

confidence: 99%

Section: Advantages Of Sgsmentioning

confidence: 99%

The Use of Silicone Adhesives for Scar Reduction

Bleasdale¹,

Finnegan

Murray

et al. 2015

Advances in Wound Care

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“…On the surface, scars may appear to be only a cosmetic concern; however, they can significantly impact the patient on many different physical and psychological levels. Physically, scars can impede the patient's range of motion, and can cause pain, dysesthesia and pruritus [5][6][7]. Patients with severely disfiguring scars may also experience such psychological symptoms such as low self-esteem and feelings of psychosocial isolation [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with severely disfiguring scars may also experience such psychological symptoms such as low self-esteem and feelings of psychosocial isolation [8,9]. Various treatments have been developed to improve the appearance of scars and to address these adverse effects, including silicone gel sheets, pressure garments, corticosteroid therapy, dermabrasion, surgical excision, chemical peels and more recently, laser treatments [7][8][9][10][11]. While some laser therapies have yielded positive results, others, such as the Nd: YAG and traditional ablative lasers, have actually worsened scar appearance [2,11,12].…”

Section: Introductionmentioning

confidence: 99%

Study of fractional ablative laser in surgical and post traumatic scar

Sobhy¹,

Adel²,

Kamal³

2012

Our Dermatol Online

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Introduction: Ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, we examined the efficacy and safety of fractional ablative 2940nm erbium: YAG laser in the treatment of surgical and post-traumatic scars. Fractional laser photothermolysis is the latest in the broad range of Er: YAG laser technique. This technique promises a novel means of providing treatments that would be as effective as traditional Er: YAG, while further reducing their down time and risk. Aim of the Work: The aim of this work is to assess the efficacy and safety of variable square pulse (VSP) fractional Er: YAG laser for the treatment of surgical and post-traumatic scars; both clinically and histopathologically. Methods: Clinical studies were conducted on a range of surgical and post-traumatic scars with a 2940nm erbium: YAG fractional ablative laser varying energy, pulse widths, treatment passes, and number of treatments: twenty subjects, with Fitzpatrick skin types III-IV, received two to five treatments at one month interval and a follow up period for 3 months. Clinical and histopathological evaluation of the results was performed. Results: Almost all patients improved both clinically and histopathologically. Clinical improvement in scars according to investigator assessment: 40% of patients had excellent improvement of 76-100% (grade 3), 50% of patients had good improvement of 50-75% (grade 2), 10% had fair improvement of 26-49% (grade 1) at three month follow up. Histologic findings demonstrated remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Conclusion: These data illustrate the safety and efficacy of the 2940nm erbium:YAG fractional ablative laser in the treatment of surgical and post-traumatic scars with short down time period, and almost no incidence of complication. StreszczenieWstęp: Ablacyjne lasery frakcyjne generują mikroskopijne kolumny poprzez koagulację tkanek naskórka i skóry właściwej wywołując reakcję gojenia ran. W tym badaniu zbadaliśmy skuteczność i bezpieczeństwo frakcyjnego ablacyjnego lasera erbowego 2940nm: YAG w leczeniu blizn chirurgicznych i pourazowych. Frakcyjna laserowa fototermoliza jest ostatnio techniką o szerokim zakresie Er: YAG. Technika ta obiecuje nowy sposób świadczenia zabiegów, które byłyby tak samo skuteczne jak tradycyjne Er: YAG, przy jednoczesnym zmniejszeniu ich czasu i ryzyka. Cel pracy: Celem niniejszej pracy jest ocena skuteczności i bezpieczeństwa stosowania zmiennego kwadratowego impulsu (VSP) frakcyjnego lasera Er: YAG do leczenia blizn chirurgicznych i pourazowych, zarówno pod względem klinicznym jak i histopatologicznym. Metody: Badania kliniczne prowadzone były w zakresie chirurgicznych i pourazowych blizn za pomocą frakcyjnego ablacyjnego lasera erbowego 2940nm: YAG różnej energii, szerokości impulsu, przebiegu leczenia i liczby zabiegów: dwudziestu pacjentów, z typami skóry Fitzpatrick III-IV...

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“…Occlusive dressings made of silicone gel are also being used to help scar maturation with reduced infection and hypertrophy although the outcomes of these interventions are not fully satisfactory. 5,6) It is generally accepted that the increase in the number of myofibroblast is directly associated with scar formation and wound contraction, and these cells are found in all contracted fibrotic tissues. [7][8][9] The α-smooth muscle actin (α-SMA) and extracellular matrix proteins, which are mainly produced by myofibroblasts, are responsible for the generation of the contractile force required for the contraction of scars.…”

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confidence: 99%

Topical application of ALK5 inhibitor A-83-01 reduces burn wound contraction in rats by suppressing myofibroblast population

Sun

Kim

Phan

et al. 2014

Bioscience, Biotechnology, and Biochemistry

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Burn scar contracture that follows the healing of deep dermal burns causes severe deformation and functional impairment. However, its current therapeutic interventions are limited with unsatisfactory outcomes. When we treated deep second-degree burns in rat skin with activin-like kinase 5 (ALK5) inhibitor A-83-01, it reduced wound contraction and enhanced the area of re-epithelialization so that the overall time for wound closing was not altered. In addition, it reduced myofibroblast population in the dermis of burn scar with a diminished deposition of its biomarker proteins such as α-SMA and collagen. Treatment of rat dermal fibroblast with A-83-01 inhibited transforming growth factor-β1 (TGF-β1)-dependent induction of α-SMA and collagen type I. Taken together, these results suggest that topical application of ALK5 inhibitor A-83-01 could be effective in preventing the contraction of burn wound without delaying the wound closure by virtue of its inhibitory activity against the TGF-β-induced increase of myofibroblast population.

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Silicon gel sheeting for preventing and treating hypertrophic and keloid scars

Cited by 61 publications

References 10 publications

The Use of Silicone Adhesives for Scar Reduction

The Use of Silicone Adhesives for Scar Reduction

Study of fractional ablative laser in surgical and post traumatic scar

Topical application of ALK5 inhibitor A-83-01 reduces burn wound contraction in rats by suppressing myofibroblast population

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