Skip to main content
Top

17-06-2024 | Silicone | ORIGINAL ARTICLE

Comparative Evaluation of Postoperative Scarring with Nasolabial Flap Reconstruction Using Silicone Gel Versus Silicone Gel Sheet: Randomized Controlled Trial

Authors: Ria Raghavan, Sonal Shah, Bhimappa Rudagi, Sakshi Gaikwad, Shubham Raut, Digvijay Shitole

Published in: Journal of Maxillofacial and Oral Surgery

Login to get access

Abstract

Aim

To evaluate and compare the postoperative scarring with nasolabial flap reconstruction using silicone gel versus silicone gel sheet.

Materials and Methods

This was an in vivo comparative study carried out in the Department of Oral and Maxillofacial Surgery. 10 patients who fit into the inclusion criteria were selected. The surgical procedure was carried out as per the standard protocol. The fishbowl method was used to allocate groups, group A where silicone gel application was prescribed and group B where silicone gel sheets were applied. On postoperative day 10, sutures were removed and the modality was advised as per the study protocol. In group A, silicone gel application was prescribed twice daily for 3 months. In group B, silicone gel sheet application was prescribed for 4 hours on day 1, increasing it by 2 hours a day till 1 week and then 24 hourly until 3 months. The patients were evaluated by a second investigator every 2 weeks until 3 months and at the end of 6 months. The healing of scars was evaluated as per the Vancouver Scar Scale.

Results

Silicone gel showed superior results than silicone gel sheet statistically in terms of pigmentation, vascularity, height and pliability (p<0.05).

Conclusion

In our study, we found an appreciable difference in the healing of scars in both groups. Although both methods aid in better healing of nasolabial scars, silicone gel offers better healing and is well tolerated by the patients.
Literature
1.
go back to reference Fabbrocini G, Marasca C, Ammad S et al (2016) Assessment of the combined efficacy of needling and the use of silicone gel in the treatment of C-section and other surgical hypertrophic scars and keloids. Adv Skin Wound Care 29(9):408–411CrossRefPubMed Fabbrocini G, Marasca C, Ammad S et al (2016) Assessment of the combined efficacy of needling and the use of silicone gel in the treatment of C-section and other surgical hypertrophic scars and keloids. Adv Skin Wound Care 29(9):408–411CrossRefPubMed
3.
go back to reference Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG (2011) Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med 17(1–2):113–125CrossRefPubMed Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG (2011) Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med 17(1–2):113–125CrossRefPubMed
4.
go back to reference Gunawardane S, Kapugama K (2017) Silicone gel for surgical scar reduction of an oral cancer patient. J Cancer Res Treat 5(1):9–14 Gunawardane S, Kapugama K (2017) Silicone gel for surgical scar reduction of an oral cancer patient. J Cancer Res Treat 5(1):9–14
5.
go back to reference El H, Jw S, Sc H (1929) The healing of wounds as determined by their tensile strength. JAMA 92(1):42–45CrossRef El H, Jw S, Sc H (1929) The healing of wounds as determined by their tensile strength. JAMA 92(1):42–45CrossRef
6.
go back to reference Pitzer GB, Patel KG (2011) Proper care of early wounds to optimize healing and prevent complications. Fac Plast Surg Clin North Am 19(3):491–504CrossRef Pitzer GB, Patel KG (2011) Proper care of early wounds to optimize healing and prevent complications. Fac Plast Surg Clin North Am 19(3):491–504CrossRef
7.
go back to reference Goodman JF, Tanna N, Arden RL et al (2011) Fundamentals Of Wound Healing, 3rd edn. Pleural Publishing, San Diego, CA Goodman JF, Tanna N, Arden RL et al (2011) Fundamentals Of Wound Healing, 3rd edn. Pleural Publishing, San Diego, CA
8.
go back to reference Fisher E, Frodel JL (2002) Wound Healing, 2nd edn. Thieme, New York, NY Fisher E, Frodel JL (2002) Wound Healing, 2nd edn. Thieme, New York, NY
9.
go back to reference Lee HJ, Jang YJ (2018) Recent understandings of biology, prophylaxis and treatment strategies for hypertrophic scars and keloids. Int J Mol Sci 19(3):711CrossRefPubMedPubMedCentral Lee HJ, Jang YJ (2018) Recent understandings of biology, prophylaxis and treatment strategies for hypertrophic scars and keloids. Int J Mol Sci 19(3):711CrossRefPubMedPubMedCentral
10.
go back to reference Surakunprapha P, Winaikosol K, Chowchuen B, Punyavong P, Jenwitheesuk K, Jenwitheesuk K (2020) A prospective randomized double-blind study of silicone gel plus herbal extracts versus placebo in pre-sternal hypertrophic scar prevention and amelioration. Heliyon 6(5):E03883CrossRefPubMedPubMedCentral Surakunprapha P, Winaikosol K, Chowchuen B, Punyavong P, Jenwitheesuk K, Jenwitheesuk K (2020) A prospective randomized double-blind study of silicone gel plus herbal extracts versus placebo in pre-sternal hypertrophic scar prevention and amelioration. Heliyon 6(5):E03883CrossRefPubMedPubMedCentral
11.
go back to reference Niessen FB, Spauwen PH, Robinson PH, Fidler V, Kon M (1998) The use of silicone occlusive sheeting (Sil-K) and silicone occlusive gel (Epiderm) in the prevention of hypertrophic scar formation. Plast Reconstr Surg 102(6):1962–1972CrossRefPubMed Niessen FB, Spauwen PH, Robinson PH, Fidler V, Kon M (1998) The use of silicone occlusive sheeting (Sil-K) and silicone occlusive gel (Epiderm) in the prevention of hypertrophic scar formation. Plast Reconstr Surg 102(6):1962–1972CrossRefPubMed
13.
go back to reference Alster TS, Tanzi EL (2003) Hypertrophic scars and keloids: etiology and management. Am J Clin Dermatol 4(4):235–243CrossRefPubMed Alster TS, Tanzi EL (2003) Hypertrophic scars and keloids: etiology and management. Am J Clin Dermatol 4(4):235–243CrossRefPubMed
14.
go back to reference Abergel RP, Pizzurro D, Meeker CA, Lask G, Matsuoka LY, Minor RR, Cbu M-L (1985) Uittoj: biocbemical composition of the connective tissue in keloids and analysis of collagen metabolism in keloid fibroblast cultures. J Invest Dermatol 84(5):384–390CrossRefPubMed Abergel RP, Pizzurro D, Meeker CA, Lask G, Matsuoka LY, Minor RR, Cbu M-L (1985) Uittoj: biocbemical composition of the connective tissue in keloids and analysis of collagen metabolism in keloid fibroblast cultures. J Invest Dermatol 84(5):384–390CrossRefPubMed
15.
go back to reference Calderon M, Lawrence WT, Banes AJ (1996) Increased proliferation in keloid fibroblasts wounded in vitro. J Surg Res 61(2):343–347CrossRefPubMed Calderon M, Lawrence WT, Banes AJ (1996) Increased proliferation in keloid fibroblasts wounded in vitro. J Surg Res 61(2):343–347CrossRefPubMed
16.
go back to reference Russell SB, Trupin JS, Kennedy RZ, Russell JD, Davidson JM (1995) Glucocorticoid regulation of elastin synthesis in human fibroblasts: down-regulation in fibroblasts from normal dermis but not from keloids. J Invest Dermatol 104(2):241–245CrossRefPubMed Russell SB, Trupin JS, Kennedy RZ, Russell JD, Davidson JM (1995) Glucocorticoid regulation of elastin synthesis in human fibroblasts: down-regulation in fibroblasts from normal dermis but not from keloids. J Invest Dermatol 104(2):241–245CrossRefPubMed
17.
go back to reference Luo S, Benathan M, Raffoul W, Panizzon RG, Egloff DV (2001) Abnormal balance between proliferation and apoptotic cell death in fibroblasts derived from keloid lesions. Plast Reconstr Surg 107(1):87–96CrossRefPubMed Luo S, Benathan M, Raffoul W, Panizzon RG, Egloff DV (2001) Abnormal balance between proliferation and apoptotic cell death in fibroblasts derived from keloid lesions. Plast Reconstr Surg 107(1):87–96CrossRefPubMed
18.
go back to reference Babu M, Diegelmann R, Oliver N (1989) Fibronectin is overproduced by keloid fibroblasts during abnormal wound healing. Mol Cell Biol 9(4):1642–1650PubMedPubMedCentral Babu M, Diegelmann R, Oliver N (1989) Fibronectin is overproduced by keloid fibroblasts during abnormal wound healing. Mol Cell Biol 9(4):1642–1650PubMedPubMedCentral
19.
go back to reference Ghahary A et al (1996) Collagenase production is lower in post-burn hypertrophic scar fibrob- lasts than in normal fibroblasts and is reduced by insulin-like growth factor-1. J Invest Dermatol 106:476–481CrossRefPubMed Ghahary A et al (1996) Collagenase production is lower in post-burn hypertrophic scar fibrob- lasts than in normal fibroblasts and is reduced by insulin-like growth factor-1. J Invest Dermatol 106:476–481CrossRefPubMed
20.
go back to reference Yoshimoto H, Ishihara H, Ohtsuru A et al (1999) Overexpression of insulin-like growth factor-1 (IGF-I) receptor and the invasiveness of cultured keloid fibroblasts. Am J Pathol 154(3):883–889CrossRefPubMedPubMedCentral Yoshimoto H, Ishihara H, Ohtsuru A et al (1999) Overexpression of insulin-like growth factor-1 (IGF-I) receptor and the invasiveness of cultured keloid fibroblasts. Am J Pathol 154(3):883–889CrossRefPubMedPubMedCentral
21.
go back to reference Xue H, Mccauley RL, Zhang W (2000) Elevated interleukin-6 expression in keloid fibroblasts. J Surg Res 89(1):74–77CrossRefPubMed Xue H, Mccauley RL, Zhang W (2000) Elevated interleukin-6 expression in keloid fibroblasts. J Surg Res 89(1):74–77CrossRefPubMed
22.
go back to reference Hoeksema H, De Vos M, Verbelen J, Pirayesh A, Monstrey S (2013) Scar management by means of occlusion and hydration: a comparative study of silicones versus a hydrating gel-cream. Burns 39(7):1437–1448CrossRefPubMed Hoeksema H, De Vos M, Verbelen J, Pirayesh A, Monstrey S (2013) Scar management by means of occlusion and hydration: a comparative study of silicones versus a hydrating gel-cream. Burns 39(7):1437–1448CrossRefPubMed
23.
go back to reference Suetak T, Sasai S, Zhen YX, Tagami H (2000) Effects of silicone gel sheet on the stratum corneum hydration. Br J Plast Surg 53(6):503–507CrossRefPubMed Suetak T, Sasai S, Zhen YX, Tagami H (2000) Effects of silicone gel sheet on the stratum corneum hydration. Br J Plast Surg 53(6):503–507CrossRefPubMed
24.
go back to reference Westra I, Pham H, Niessen FB (2016) Topical silicone sheet application in the treatment of hypertrophic scars and keloids. J Clin Aesthet Dermatol 9(10):28–35PubMedPubMedCentral Westra I, Pham H, Niessen FB (2016) Topical silicone sheet application in the treatment of hypertrophic scars and keloids. J Clin Aesthet Dermatol 9(10):28–35PubMedPubMedCentral
25.
go back to reference Mukherjee T, Chopra S, Aggarwal A, Garg V, Dadwal H, Sharma P (2021) Surgical scar revision using silicone gel sheet as an adjunct. Natl J Maxillofac Surg 12(1):36–41CrossRefPubMedPubMedCentral Mukherjee T, Chopra S, Aggarwal A, Garg V, Dadwal H, Sharma P (2021) Surgical scar revision using silicone gel sheet as an adjunct. Natl J Maxillofac Surg 12(1):36–41CrossRefPubMedPubMedCentral
26.
go back to reference Pruksapong C, Burusapat C, Hongkarnjanakul N (2020) Efficacy of silicone gel versus silicone gel sheet in hypertrophic scar prevention of deep hand burn patients with skin graft: a prospective randomized controlled trial and systematic review. Plast Reconstr Surg Glob Open 8(10):E3190CrossRefPubMedPubMedCentral Pruksapong C, Burusapat C, Hongkarnjanakul N (2020) Efficacy of silicone gel versus silicone gel sheet in hypertrophic scar prevention of deep hand burn patients with skin graft: a prospective randomized controlled trial and systematic review. Plast Reconstr Surg Glob Open 8(10):E3190CrossRefPubMedPubMedCentral
27.
go back to reference Mustoe TA (2008) Evolution of silicone therapy and mechanism of action in scar management. Aesthetic Plast Surg 32(1):82–92CrossRefPubMed Mustoe TA (2008) Evolution of silicone therapy and mechanism of action in scar management. Aesthetic Plast Surg 32(1):82–92CrossRefPubMed
28.
go back to reference De Giorgi V, Sestini S, Mannone F et al (2009) The use of silicone gel in the treatment of fresh surgical scars: a randomized study. Clin Exp Dermatol 34(6):688–693CrossRefPubMed De Giorgi V, Sestini S, Mannone F et al (2009) The use of silicone gel in the treatment of fresh surgical scars: a randomized study. Clin Exp Dermatol 34(6):688–693CrossRefPubMed
29.
go back to reference Fulton JE Jr (1995) Silicone gel sheeting for the prevention and management of evolving hypertrophic and keloid scars. Dermatol Surg 21:947–951CrossRefPubMed Fulton JE Jr (1995) Silicone gel sheeting for the prevention and management of evolving hypertrophic and keloid scars. Dermatol Surg 21:947–951CrossRefPubMed
30.
go back to reference Lin YS, Ting PS, Hsu KC (2018) Does the form of dressings matter?: A comparison of the efficacy in the management of postoperative scars between silicone sheets and silicone gel: a randomized controlled trial. Medicine (Baltimore) 97(32):E11767CrossRefPubMedPubMedCentral Lin YS, Ting PS, Hsu KC (2018) Does the form of dressings matter?: A comparison of the efficacy in the management of postoperative scars between silicone sheets and silicone gel: a randomized controlled trial. Medicine (Baltimore) 97(32):E11767CrossRefPubMedPubMedCentral
31.
go back to reference Ahn ST, Monafo WW, Mustoe TA (1991) Topical silicone gel for the prevention and treatment of hypertrophic scar. Arch Surg 126(4):499–504CrossRefPubMed Ahn ST, Monafo WW, Mustoe TA (1991) Topical silicone gel for the prevention and treatment of hypertrophic scar. Arch Surg 126(4):499–504CrossRefPubMed
32.
33.
go back to reference Berman B, Flores F (1999) Comparison of a silicone gel-filled cushion and silicon gel sheeting for the treatment of hypertrophic or keloid scars. Dermatol Surg 25(6):484–486CrossRefPubMed Berman B, Flores F (1999) Comparison of a silicone gel-filled cushion and silicon gel sheeting for the treatment of hypertrophic or keloid scars. Dermatol Surg 25(6):484–486CrossRefPubMed
34.
go back to reference Carney SA, Cason CG, Gowar JP et al (1994) Cica-care gel sheeting in the management of hypertrophic scarring. Burns 20(2):163–167CrossRefPubMed Carney SA, Cason CG, Gowar JP et al (1994) Cica-care gel sheeting in the management of hypertrophic scarring. Burns 20(2):163–167CrossRefPubMed
35.
go back to reference Borgognoni L, Martini L, Chiarugi C, Gelli R, Giannotti V, Reali UM (2000) Hypertrophic scars and keloids: immunophenotypic features and silicone sheets to prevent recurrences. Ann Burns Fire Disasters 13(3):164–169 Borgognoni L, Martini L, Chiarugi C, Gelli R, Giannotti V, Reali UM (2000) Hypertrophic scars and keloids: immunophenotypic features and silicone sheets to prevent recurrences. Ann Burns Fire Disasters 13(3):164–169
36.
go back to reference Kwon SY, Park SD, Park K (2014) Comparative effect of topical silicone gel and topical tretinoin cream for the prevention of hypertrophic scar and keloid formation and the improvement of scars. J Eur Acad Dermatol Venereol 28(8):1025–1033CrossRefPubMed Kwon SY, Park SD, Park K (2014) Comparative effect of topical silicone gel and topical tretinoin cream for the prevention of hypertrophic scar and keloid formation and the improvement of scars. J Eur Acad Dermatol Venereol 28(8):1025–1033CrossRefPubMed
37.
go back to reference Gold MH, Foster TD, Adair MA, Burlison K, Lewis T (2001) 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 27(7):641–644PubMed Gold MH, Foster TD, Adair MA, Burlison K, Lewis T (2001) 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 27(7):641–644PubMed
38.
go back to reference Wang F, Li X, Wang X, Jiang X (2020) Efficacy of topical silicone gel in scar management: a systematic review and meta-analysis of randomised controlled trials. Int Wound J 17(3):765–773CrossRefPubMedPubMedCentral Wang F, Li X, Wang X, Jiang X (2020) Efficacy of topical silicone gel in scar management: a systematic review and meta-analysis of randomised controlled trials. Int Wound J 17(3):765–773CrossRefPubMedPubMedCentral
Metadata
Title
Comparative Evaluation of Postoperative Scarring with Nasolabial Flap Reconstruction Using Silicone Gel Versus Silicone Gel Sheet: Randomized Controlled Trial
Authors
Ria Raghavan
Sonal Shah
Bhimappa Rudagi
Sakshi Gaikwad
Shubham Raut
Digvijay Shitole
Publication date
17-06-2024
Publisher
Springer India
Keyword
Silicone
Published in
Journal of Maxillofacial and Oral Surgery
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-024-02228-y
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare