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Possible Mechanisms of Action for silicone sheeting:
Changes
in temperature and oxygen tension (1985 Burns, Quinn, et el)
Reduces water vapor loss, restores homeostasis, reduces
capillary hyperemia and collagen deposition (1991 Burns, Davey, et el)
Creates a static electrical field (1993 Hershowitz,
et el)
Positive electrical stimulation reduces vascularity, decreases mast cells and, increased temperature, increases
the activity of collagenase (1991 Reich, et el)
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Silicone
Scar Studies:
1. Ahn ST, Monafo WW, Mustoe TA. Topical silicone gel for the prevention and treatment of hypertrophic
scars. Arch Surg. 1991;126:499-504.
2. Ahn ST, Monafo WW, Mustoe TA. Topical silicone gel: A new treatment for hypertrophic
scars. Surgery. 1989;106:781-787.
3. Quinn KJ. Silicone gel in scar treatment. Burns. 1987:13:S33-S40.
4. Sawada
Y, Yotsuyanagi T, Sone K. A silicone gel sheet dressing containing an antimicrobial agent for split thickness donor site wounds.
Br J Plastic Surg. 1990;43:88-93.
5. Sawada Y, Yotsuyanagi T, Ara M, et al. Experiences using silicone gel tie-over
dressings following skin grafting. Burns. 1990;16:353-357.
6. Sawada Y, Ara M, Yotsuyanagi T, et al. Treatment of dermal
depth burn wounds with an antimicrobial agent-releasing silicone gel sheet. Burns. 1990;16:347-352.
7. Gibbons M, Zuker
R, Brown M, et al. Experience with silastic gel sheeting in pediatric scarring. J Burn Care Rehabil. 1994;15(1):69-73.
8. Carney SA, Cason CG, Gowar JP, et al. Cica-Care gel sheeting in the management of hypertrophic scarring. Burns. 1994;20(2):163-167.
9. Sherris DA, Larrabee WF Jr., Murakami CS. Management of scar contractures, hypertrophic scars, and keloid. Otolaryngol
Clin North Am. 1995;28(5):1057-1068.
10. Tilkorn H, Ernst K, Osterhaus A, et al. The protruding scars: Keloids and hypertrophic.
Diagnosis and treatment with silicon-gel-sheeting. Polymers Med. 1994;24(1-2):31-44.
11. Palmieri B, Gozzi G, Palmieri
G. Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids. Intern J Dermatol. 1995;34(7):506-509.
12. Fulton JE Jr. Silicone gel sheeting for the prevention and management of evolving hypertrophic and keloid scars.
Dermatol Surg. 1995;21:947-951.
13. Ricketts CH, Martin L, Faria DT, et al. Cytokine mRNA changes during the treatment
of hypertrophic scars with silicone and nonsilicone gel dressings. Dermatol Surg. 1996; 22(11):955-959.
14. Gold MH.
A controlled clinical trial of topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. J Am Acad
Dermatol. 1994;30:506-507.
15. Gold MH. Topical silicone gel sheeting in the treatment of hypertrophic scars and keloids.
J Dermatiol Surg Oncol. 1993;19:912-916.
16. Katz BE. Silicone gel sheeting in scar therapy. Cutis. 1995;56:65-67.
17. Klopp R, Niemer W, Fraenkel M, von der Weth A. Effect of four treatment variants on the functional and cosmetic state
of mature scars. J Wound Care. 2000;9(7):319-324.
18. de Oliveira GV, Nunes TA, Magna LA, et al. Silicone versus nonsilicone
gel dressings: A controlled trial. Dermatol Surg. 2001;27(8):721-726.
19. Gold MH, Foster TD, Adair MA, et al. Prevention
of hypertrophic scars and keloids by the prophylactic use of topical silicone gel sheets following a surgical procedure in
an office setting. Dermatol Surg. 2001;27(7):641-644.
20. Wittenberg GP, Fabian BG, Bogomilsky JL, et al. Prospective,
single-blind, randomized, controlled study to assess the efficacy of the 585-nm flashlamp-pumped pulsed-dye laser and silicone
gel sheeting in hypertrophic scar treatment. Arch Dermatol. 1999;135(9):1049-1055.
21. O'Brien L. Silicon gel sheeting
for preventing and treating hypertrophic and keloid scars (Protocol for a Cochrane Review). In: The Cochrane Library, Issue
4, 2002. Oxford, UK: Update Software.
22. Niessen FB, Spauwen PH, Robinson PH, et al. The use of silicone occlusive
sheeting (Sil-K) and silicone occlusive gel (Epiderm) in the prevention of hypertrophic scar formation. Plast Reconstr Surg.
1998;102(6):1962-1972.
23. Lee SM, Ngim CK, Chan YY, Ho MJ. A comparison of Sil-K and Epiderm in scar management. Burns.
1996;22(6):483-487.
24. Sproat JE, Dalcin A, Weitauer N, Roberts RS. Hypertrophic sternal scars: Silicone gel sheet
versus Kenalog injection treatment. Plast Reconstr Surg. 1992;90(6):988-992.
25. Sawada Y, Sone K. Treatment of scars
and keloids with a cream containing silicone oil. Br J Plast Surg. 1990;43(6):683-688.
26. Quintal EJ. Keloids. In:
Conn's Current Therapy. 54th ed. RE Rakel, ET Bope, eds. Philadelphia, PA: W.B. Saunders Co.; 2002:798-801.
27. Shaffer
JJ, Taylor SC, Cook-Bolden F. Keloidal scars: A review with a critical look at therapeutic options. J Am Acad Dermatol. 2002;46(2):S63-S97.
28. Porter JP. Treatment of the keloid. What's new? Otolaryngol Clin North Am. 2002;35(1):207-220, viii.
29. Brown
CA. The use of silicon gel for treating children's burn scars in Saudi Arabia: A case study. Occup Ther Int. 2002;9(2):121-30.
30. Eishi K, Bae SJ, Ogawa F, et al. Silicone gel sheets relieve pain and pruritus with clinical improvement of keloid:
Possible target of mast cells. J Dermatolog Treat. 2003;14(4):248-252.
31. Food and Drug Administration. HHS. General
and plastic surgery devices; Classification of silicone sheeting. Final rule. Fed Regist. 2004;69(152):48146-48148.
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Abstract |
Dermatologic
Surgery
Volume 25 Issue 4 Page 267 - April 1999
doi:10.1046/j.1524-4725.1999.08240.x | | Volume 25 Issue 4 | | | | | | Pilot Study Evaluating Topical Onion Extract as Treatment for Postsurgical
Scars | Brooke A. Jackson, MD,* and Andrea J. Shelton, PhD | Background.
Post surgical scars can be erythematous, raised, pruritic and painful. Numerous modalities
are available to improve the appearance and symptomatology of these scars. A topical onion gel extract is the newest in the
armamentarium of scar treatments. The active ingredient in this gel is allium cepa. Published studies evaluating the usefulness
of this gel in the treatment of scars are not available. Objective. To evaluate the effectiveness of topical
onion gel extract in improving the appearance and symptomatology of postsurgical scars and to compare the results of its use
to those of a topical emollient ointment. Methods. Seventeen patients with surgical scars resulting
from Mohs surgery were assigned to 1 of 2 groups on the day of suture removal. Each group applied a designated topical product
3 times a day for 1 month. Photographic documentation and questionnaires using a visual analog scale were completed for each
scar enrolled in the study. ResultsUsing the Fischer's exact test, no statistically significant difference
between pre- and posttreatment evaluations of scar erythema and pruritus in patients using topical onion extract gel was found.
A statistically significant reduction in scar erythema was found in patients using a petrolatum based ointment. Conclusions. Scar hydration is an important factor in wound healing and can be achieved with topical petrolatum-based ointment.
Topical onion gel extract was ineffective in improving scar erythema and pruritus in our patients. |
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