The Efficacy of Silicone Gel for the Treatment of Hypertrophic Scars

Topical self drying silicone gel is a relatively recent treatment modality promoted as an alternative to topical silicone gel sheeting. Thirty patients with scars of different types including superficial scars, hypertrophic scars, and keloids were treated with silicon gel application. The results of the self-drying silicone gel have been satisfactory.

Scars vary greatly in quality, depending on individual patient features, the nature of the trauma, and the conditions of wound healing. They frequently determine aesthetic impairment and may be symptomatic, causing itching, tenderness, pain, sleep disturbance, anxiety, depression and disruption of daily activities. Other psychological sequelae include posttraumatic stress reactions, loss of self esteem and stigmatization leading to a diminished quality of life. Scar contractures also can determine disabling physical deformities. All these problems are more troublesome to the individual patient, particularly when the scar cannot be hidden by clothes. This study was undertaken to verify the efficacy of a new topical silicone treatment; a self-drying spreadable gel that needs no means of fixation and cannot be seen because of complete transparency.

Written informed consent was taken from all the patients before the study. Also, prior approval of hospital ethical committee was taken before the study. The silicone gel was applied as a thin film twice a day. It was rubbed with fingertips for 2-3 minutes. For fresh scars, treatment was started just days after wound closure or after 5-10 days. The scars were evaluated at monthly intervals. The appearance of scar, including scar type, scar size and scar color was assessed by the physician. We classified hypertrophic scar as a red or dark pink, raised (elevated) sometimes itchy scar confined within the border of the original surgical incision, with spontaneous regression after several months and a generally poor final appearance. A keloid is instead classified as a scar red to brown in color, very elevated, larger than the wound margins very hard and sometimes painful or pruritic with no spontaneous regression.

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