STATIC-ELECTRIC FIELD INDUCTION BY A SILICONE CUSHION FOR THE TREATMENT OF HYPERTROPHIC AND KELOID SCARS

Silicone gel and silicone occlusive sheeting are widely used at presen t for the treatment of hypertrophic and keloid scars, without ally sci entific explanation as to their mode of action. In a recent paper the possibility was raised that static electricity generated by friction-a ctivated silicone sheeting could be the reason for this effect, and th at it call, with time, cause involution of hypertrophic and keloid sca rs. The objective of this study was to test this hypothesis and to obs erve whether a continuous and also an increased negatively charged sta tic-electric field will shorten the treatment period. A device to impl ement these requirements gradually evolved over a 5-year period. A num ber of prototypes were tested until the final product was attained. So me of the patients in this study were treated initially with a silicon e sponge inserted in the cushion. Later this version was changed to th e final design described herein. A silicone cushion was developed with the purpose of increasing a negative static-electric charge to accele rate the regression process. The cushion is custom-made using a silico ne occlusive sheeting envelope of 0.75-mm thickness, which does not de teriorate with use, and is partially filled with high viscosity silico ne oil. Its edges are sealed, and its size is designed to extend a lit tle beyond the scarred area. Static electricity readings, generated by activating the cushion by pumping action with the fingers, stretching or deforming the cushion, are invariably much higher when compared wi th those obtained with silicone occlusive sheeting and silicone gel sh eeting. The interaction between the negatively charged ions of the cus hion and the ionic charges of the tissue fluids may be the critical fa ctor in achieving hypertrophic and keloid scars involution. Of the 30 patients enrolled in the study, 3 patients dropped out. Treatment with the silicone cushions yielded 63.3 percent cessation of itching and b urning followed by pallor and flattening of the scar, some markedly so , over a few weeks to 6-month period. An additional 26.6 percent had t heir scars resolved in up to 12 months of treatment. Good contact of t he cushion over the scar has been shown to be important ill this clini cal trial, and much creativity is needed for making elastic strap bind ings that ensure this contact. The clinical trials extended over a 12- month period. Ten patients (33.3 percent) who had recalcitrant scars w ith little response to the use of the silicone cushion were given intr alesional corticosteroid injections, in addition to the continued use of the cushion, resulting in a fairly rapid resolution of these scars over a period of months to a year.