Use of silicone gel sheets in combination with pressure garments in prevention of hypertrophic scarring; is it effective?

ABSTRACT

Patients can have a wide range of problems related to scars, in terms of cosmesis, function, symptoms, psychological problems and overall quality of life issues. Hypertrophic scars can be reduced by the application of silicone dressing; however, the detailed mechanism of silicone action is still unknown. It is known that silicone gel sheets Cerederm[R] cause a hydration of the epidermal layer of the skin. An in vitro coculture experiment has shown that hydration of keratinocytes had a suppressive effect on the metabolism of the underlying fibroblasts resulting in reduced collagen deposition. This study was conducted on 80 linear scars, 40 patients with post abdominoplasty scars, and 20 patients [40 breasts] with reduction mammoplasty scars; they were divided into two groups with the use of pressure garment fixed in both groups. The first group used silicone gel sheet Cerederm [R] while the second did not. Both groups were followed up for a period of 6 months. Then the outcome was compared both on clinical and histopathological basis. On clinical assessment the two groups where compared according to the Vancouver Scar Scale [VSS.] scar height, pigmentation .etc. While in histopathological examination, three biopsies were taken at day 0, 90, 180 respectively. Each specimen was stained by hematoxylin and eosin to show the normal pattern of collagen bundle formation, the amount of fibrosis and proliferation of the fibroblasts. Early restoration of the water barrier is essential for reducing the stimulus for epidermal proliferation, and secondary epidermal cross talk to stimulate collagen synthesis in the dermis. Adding the pressure garment to the silicon play a role in decreasing the height of the scar or prevent its formation with decrease the other unpleasant sequel of the scar