VITAMIN-E ADDED SILICONE GEL SHEETS FOR TREATMENT OF HYPERTROPHIC SCARS AND KELOIDS

Background. Trauma of various origins can induce a connective tissue d isorder that leads to keloids. This condition has yet not been clearly distinguished from scars and hypertrophic scars. Only electronmicrosc opic and biochemical data can help to do this. Among some more or less therapeutic approaches, the use of silicon (polydimethylsiloxane) pla tes, wrapped on the keloid surface, has been reported effective by som e authors. These authors also demonstrated that it is not the mechanic al pressure that is the mechanism of action, but a direct action on fi broblasts and a hyperhydration of subcutaneous tissue. The authors of this study conceived that the silicon plate may be able to improve the transdermal penetration of a compound such as vitamin E. This vitamin is capable of preserving some important morphologic and functional fe atures of biological membranes by means of its phytilside chain of the molecule acting as a stabilizer of lysosomal membranes. Materials and Methods. Eighty patients of both sexes, aged between 18 and 63 years, who had hypertrophic scars and keloids, were admitted to the trial. T he patients were randomized to two groups in a simple-blinded study. G roup A: Forty patients whose scars have been covered with silicon plat es with added vitamin E. Group B: Forty patients treated with simple s ilicone gel sheets. No pressure bandages were used, only tape fixing t he sheet for 10 hours overnight. The trial lasted for 2 months. The re sults were recorded at 4 and 8 weeks, evaluating the improvement accor ding to a Scott-Husskinson scale. For objective assessment photos were taken. The results were analyzed by the chi-square test. Results. At the end of the first month, group A had improved by more than 50% in 8 5% of cases, whereas the improvement in group B was 55% (P < 0.01). Al the end of the second month, 95% of patients in group A had improved by 50%, whereas 75% had improved by 50% in group B (P < 0.05). Conclus ions. Vitamin E added to the silicon plate scored better than the simp le silicon plate at the end of both periods. We have reported the succ essful combined action of vitamin E and silicone gel sheets in scar tr eatment, especially in the short-term prophylaxis of hypertrophic scar s or keloids.