EVALUATION OF SILICONE-GEL SHEETING ON EARLY WOUND-HEALING OF LINEAR INCISIONS

Topical silicone-gel sheeting has been shown to be beneficial in the t reatment of established hypertrophic and keloid scars. Certain individ uals and incisions in specific body sites appear to be at increased ri sk for the development of such scars. A simple, inexpensive, and preve ntive treatment in these individuals at increased risk could potential ly minimize the extended period of pressure therapy and repeated stero id injections that are often required to optimize outcome. However, th e effects of applying silicone-gel sheeting in the immediate postopera tive period as a preventive measure have not been investigated to date . Because silicone-gel sheeting influences the remodeling and maturati on phase of collagen formation, we believed it prudent to determine wh ether silicone-gel sheeting had any deleterious effect on early wound healing, as demonstrated by in vivo biomechanical testing of wound str ength and histological assessment. To investigate the potential effect s of silicone-gel sheeting on acute wound healing and its possible app lication for prevention of hypertrophic scars, a study was designed in the hairless guinea pig. In phase 1 of the study, bilateral dorsolate ral incisions were made, allowing each guinea pig to serve as its own control. One wound was dressed with silicane-gel sheeting, and the con trol site was dressed with Nu-gauze dressing, Wounds were then assesse d visually and with in vivo biomechanical analysis of wound strength a t days 3, 5, and 7 postoperatively (n = 7 per group). Phase 2 of the s tudy compared identical dressings in a similar animal model using a si ngle dorsal midline incision, in which alternate halves of each wound served as the control. Each wound was assessed histologically at days 3, 7, and 14 (n = 5 per group). Despite an improved subjective appeara nce of those wounds treated with the silicone sheeting applied at the time of incision closure in the hairless guinea pig model, no signific ant adverse or beneficial effect on in vivo wound healing strength on days 3, 5, and 7 was demonstrated compared with controls when analyzed using a paired observation t-test (p = 0.35, 0.20, and 0.47, respecti vely). Blinded interpretation of histological specimens showed no diff erence an hematoxylin and eosin or trichrome staining between the test and control sites at any interval assessed in this study, We believe this information confirms the safety of applying silicone-gel sheeting at wound closure in this model and thus opens the door for subsequent clinical trials to assess the role of these products in preventing hy pertrophic or keloid scars.