This article gives an overview of the use of silicones in the treatment and
prevention of hypertrophic (burn related) scars. Of all non-invasive treat
ment modalities the use of continuous pressure and occlusive contact media,
e.g. silicones, seem to be generally accepted as the only ones that are ab
le to manage hypertrophic scarring without significant side-effects. A summ
ary of the current opinions of the assumed working mechanisms of pressure a
s well as silicones is given. The use of silicones, either alone or in comb
ination with pressure, is discussed. The recent development of custom made
silicone devices has led to combinations of both modalities. Some of these,
including the inflatable silicone insert systems (ISIS (R)), are shown and
discussed. (C) 2001 Elsevier Science Ltd and ISBI. All rights reserved.