The Efficacy of a Silicone Sheet in Postoperative Scar Management

Kim, Jin Sam; Hong, Joon Pio; Choi, Jong Woo; Seo, Dong-Kyo; Lee, Eun Sook; Lee, Ho Seong

doi:10.1097/01.asw.0000488665.03896.3d

Cited by 19 publications

(16 citation statements)

References 15 publications

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“…A prospective, randomized, blinded, intraindividual comparison study evaluated the use of silicone sheet in patients who underwent a bilateral surgical hallux valgus incision scar 26 . At the time of suture removal, patients applied a silicone sheet to the scar of one foot and no product on the other side (control group).…”

Section: Siliconementioning

confidence: 99%

Summary and evidence grading of over‐the‐counter scar treatments

Grigoryan

Kampp

2020

Int J Dermatology

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Background Many products claiming to improve scar appearance are readily available on the Internet. Data behind these claims are often difficult to find or summarize. Patients often ask their surgeon for advice for scarring postdermatologic surgery. Objective We aim to review the evidence behind several advertised products and techniques that claim to improve postsurgical scarring. Methods A PubMed search was performed using products and methods claiming to improve scar appearance along with the terms “scar” and “scarring”. Results Published literature on scar massage, taping of scars, silicone gel and sheeting, onion‐based extract products, and vitamin E was reviewed. Silicone gel/sheeting as well as taping have the most evidence to help improve scarring, but even then the evidence is conflicting and weak. Conclusion Online advertising may tempt patients to buy and trial products to help minimize scarring, although the evidence for the effectiveness of these products is absent to minimal. Dermatologists must be aware of these products to maintain effective patient counseling.

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Section: Siliconementioning

confidence: 99%

Summary and evidence grading of over‐the‐counter scar treatments

Grigoryan

Kampp

2020

Int J Dermatology

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“…From the surgeon's perspective, poor scarring may impede range of motion, alter one's gait, and complicate return to certain shoe gear or activity, which can lead to poor patient outcomes. 3 …”

Section: Introductionmentioning

confidence: 99%

“…One of the most widely utilized dressing for the prevention of hypertrophic and keloid scars in postsurgical patients is silicone gel sheeting. 3 , 15 , 16 While the mechanism of action is not completely understood, the silicone creates an occlusive environment, which thereby promotes hydration as the scar remodels. These dressings are often described as being consumer-friendly, as they are non-invasive and can be applied by patients within their own homes.…”

Section: Introductionmentioning

confidence: 99%

The effect of a silver hydrogel sheet dressing on postsurgical incision healing after foot and ankle surgery

Miner

Protzman

Brigido

2022

Scars, Burns & Healing

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Introduction Silver hydrogel dressings are antimicrobial dressings with the potential to aid post-surgical healing. The purpose of this study is to evaluate the effects of a silver hydrogel dressing on postoperative scarring and complications. Methods 40 foot and ankle patients (48.43 ± 16.82 years) were included in the study with 20 patients in each group. Postoperatively, the treatment group was treated with a silver hydrogel sheet dressing, and the control group was treated with a standard petroleum-based dressing. Follow-up was performed at two, six, and 12 weeks. Postoperative scarring and complications were evaluated and compared between groups. Scarring was evaluated using the Patient and Observer Scar Assessment Scale (POSAS). Scar length and width were measured using digital calipers and used to compute scar area. Results The treatment group demonstrated statistically significant improvements in the POSAS observer score and observer opinion at six and 12 weeks ( p < 0.001). Additionally, patient reported pain was significantly lower for the treatment group than the control group at 12 weeks ( p < 0.001). Patient reported itch declined across time for both groups ( p < 0.001) with significantly less itching reported by the treatment group ( p = 0.027). Scar area was also significantly lower for the treatment group than the control group at six weeks and 12 weeks ( p ≤ 0.002). Neither group experienced any postoperative complications. Conclusion These results suggest that the inherent properties of the silver hydrogel dressing may improve postsurgical scarring. Lay Summary Surgical incisions result in scar, which can present both cosmetic and rehabilitation concerns after foot or ankle surgery. It is standard to use a petroleum-based dressing on incisions after surgery, however, advancements in incisional dressings have been made over the past 20 years. One such advancement is silver-impregnated hydrogel sheet dressings which have been shown to maintain a moist wound environment conducive to healing, while decreasing the chance of infection through its antimicrobial properties. This paper evaluates scar healing after foot or ankle surgery in patients treated with either the standard petroleum-based dressing, or the silver hydrogel sheet dressing. Patients who were treated with the silver hydrogel dressing had less itching and pain, as well as a smaller scar area than patients in the standard dressing group. Therefore, our results suggest that the silver hydrogel dressing may improve scarring after surgery.

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“…Silicone dressing is hypothesized to act by hydrating the wound, inhibiting collagen deposition, and downregulating TGF-β2 ( 20 ). Hydrated and occluded environment impairs capillary activity and the continuation of subsequent pathological regeneration signals ( 21 ). This affects fibroblast regulation and reduces synthesis of collagen ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Network Meta-Analysis of Different Clinical Commonly Used Drugs for the Treatment of Hypertrophic Scar and Keloid

Yang

Luo

2021

Front. Med.

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Background: There is no uniform treatment for pathological scars, including keloids and hypertrophic scars, in clinic currently. Previously, multiple randomized controlled trials have examined the clinical efficacy of different treatments. Nonetheless, the results are inconsistent, and many treatments have not been directly compared. This makes it difficult to conclude which approach is more favorable, in terms of efficacy and safety, for the treatment of pathological scarring. This study aimed at evaluating the efficacy of different injection and topical treatment strategies for hypertrophic scar and keloid.Methods: Relevant literature from PubMed, Medline, Embase, Scopus, the Cochrane Central Register of Controlled Trials (CCRCT), and WHO International Clinical Trials Registry Platform (WHO-ICTRP) were searched, from database inception through November 2020. Randomized clinical trials evaluating different treatment strategies of pathological scars, including triamcinolone acetonide (TAC), verapamil (VER), 5-fluorouracil (5-FU), botulinum toxin A (BTA), bleomycin (BLM), and silicone gels were included in the study.Results: The network meta-analysis included a total of 2,009 patients from 29 studies. A network meta-analysis of injection and topical treatment strategies showed that the efficacy of TAC combined with BTA was best in the treatment of pathological scars. Combination therapies of TAC with 5-FU and TAC with BTA significantly improved the clinical efficiency. However, there was no statistically significant difference between other treatment strategies. The order of efficacy predicted by the surface under the cumulative ranking (SUCRA) curve was as follows: TAC+BTA (82.2%) > TAC+5-FU (69.8%) > BTA (67.3%) > 5-FU+silicone (59.4%) > TAC+silicone (58.3%) > 5-FU (49.8%) > BLM (42.0%) > TAC (26.7%) > VER (26.2%) > silicone (18.3%). There was no publication bias revealed based on the funnel diagram.Conclusion: This study recommends intralesional injection of TAC-BTA and TAC-5-FU combined therapies. But for patients who cannot tolerate the side effects, the use of silicone gels in combination with TAC is recommended. However, these conclusions need to be further confirmed by more randomized controlled trials.

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The Efficacy of a Silicone Sheet in Postoperative Scar Management

Abstract: To the authors' knowledge, this is one of the first models to minimize bias related to scar evaluation by using symmetrical scars. The early silicone sheet application did show a significant improvement in prevention of postoperative scarring.

Cited by 19 publications

References 15 publications

Summary and evidence grading of over‐the‐counter scar treatments

Summary and evidence grading of over‐the‐counter scar treatments

The effect of a silver hydrogel sheet dressing on postsurgical incision healing after foot and ankle surgery

Network Meta-Analysis of Different Clinical Commonly Used Drugs for the Treatment of Hypertrophic Scar and Keloid

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