Adhesive Silicone Gel Sheet for Treatment of Nailbed Injury

If autogenous nail is lost in nail bed injuries, alternative effective nail bed protection material is questionable in postoperative follow up period. The conventional modality with autogenous nail coverage have several disadvantages such as drawback of maintenance, higher chance of loss and complex dressing step (eg. ointment apply for humidification and nail fixation using tape or bandage). So, we have studied the usefulness of adhesive silicone gel sheet for alternative nail bed protection material until the end of nail regeneration. From March 2003 to July 2004, we have experienced 215 traumatic nail bed injuries except fingertip loss. Among these patient, we classified two groups, 30 cases with autogenous nail protection(Group I) and 30 cases with adhesive silicone gel sheet protection(Group II). Mean full nail growth time was 3.6 months in group I and 3.8 months in group II. Mean final nail appearance score(0: poor, 4: excellent) was 3.0 in group I and 3.5 in group II. Adhesive silicone gel sheet protection(Group II) was slightly superior to the autogenous nail protection in final appearance, especially sterile matrix laceration. In conclusion, we believe that adhesive silicone gel sheet application is a simple, acceptable, alternative method for protecting nail bed with loss of autogenou nail. It has a number of advantages compared with autogenous nail such as better humidification, controllable hygiene, less pain, less hospitalization, less frequent visit, less chance of loss, avoiding complex dressing step and more even pressure with adhesiveness, flexibility and durability.

Conservative Treatment with Silicone Gel Sheet of Aplasia Cutis Congenita: Case Reports

Aplasia cutis congenita represents a congenital absence of all skin layers, and it may occasionally extend through the bone and dura of the skull. Since the first report by Cordon in 1767, over 500 cases have been reported. Eighty percents of all cases are found in the scalp, and 20 percents of these cases involve extremities and trunk and are often bilaterally symmetrical. Histologic examination demonstrates a layer of thin dermal collagen without overlying epithelium or adnexal structures. It has several clinical groups classified by the location and pattern of the skin defect, associated anomalies and the mode of inheritance. Its management is controversial and may be conservative treatment or the surgical option to provide definite skin cover. In 1990, Wexler suggested that conservative treatment using Silvadene was the preferred option. We would like to present 2 cases in which silicone gel sheet as a conservative treatment modality led to favorable outcomes. It was invented for the treatment of hypertrophic scar but has been used and studied for the open wounds in recent years. The use of silicone gel sheet on congenital skin defect has many advantages: the danger of infection is minimized due to frequent washing; prolonged hospitalization is prevented; pain or bleeding is minimized for dressing changes because it doesn't adhere to the wound; and it can be used after the epithelization for the prevention of hypertrophic scar.

Efficacy of Tie-over Dressing Using Silicone Gel Sheet in Skin Graft on Flat Surface

Success of skin grafts depends on sufficient immobilization and early intervention for hematoma, seroma, or infection. To stabilize and cover skin grafts with a tie-over technique was used with translucent silicone gel sheet on flat surface. Skin defect was resurfaced with skin grafts. A sterile silicone gel sheet was placed over the skin graft. Gel was fixed to the wound edges with skin sutures. Skin graft healed without any complications. Using silicone gel sheet in skin graft on flat surface is an effective method for stabilization, which also allows direct visualization of the graft designed to inspect hematoma-like complications.