Saulis Alexandrina S, Chao Jerome D, Telser Alvin, Mogford Jon E, Mustoe Thomas A
Wound Healing Research Laboratory, Division of Plastic Surgery, Northwestern University Medical School, Chicago, IL, USA .
Aesthet Surg J. 2002 Mar;22(2):147-53. doi: 10.1067/maj.2002.123023.
Hypertrophic scar formation at sites of healed cutaneous injury often produces functional and esthetic deficits. Treatments have been limited in part by a lack of understanding of scar etiology and the lack of animal models of hypertrophic scarring. Silicone dressing is reported to provide positive outcomes with respect to a reduction in scar hypertrophy and an improvement in color differences, although the exact mechanism is unknown.
We tested the effectiveness of silicone adhesive gel in the reduction of scar hypertrophy in an animal model of scarring.
Silicone adhesive gel was applied to scars in a rabbit ear model of hypertrophic scarring. Scarring in this model, which displays reduced hypertrophy in response to steroid injections and aging similar to that of human beings, was measured by the Scar Elevation Index (SEI), a ratio of the scar height over normal skin, in which readings greater than 1.0 represent a raised scar.
SEIs were significantly reduced after 4-week applications of silicone gel (1.15 +/- 0.15 vs 1.71 +/- 0.33, respectively; P < .001) versus untreated scars. Nonsilicone control dressings did not alter SEIs in comparison with those found for controls. No histologic differences in scar cellularity, inflammation, or matrix organization were found between treatment groups; however, ultrastructural observation revealed numerous vacuoles in basal cells of control and nonsilicone-treated scars that were not found in unwounded skin or silicone gel-treated scars. The similarity in water vapor transmission rates for silicone gel and a nonsilicone dressing eliminated scar hydration as the sole mechanism of action of the silicone dressings.
Our findings with the rabbit model demonstrate the effectiveness of silicone gel for hypertrophic scar treatment and confirm the usefulness of this model for further study of the mechanism of occlusion. (Aesthetic Surg J 2002;22:147-153.).
皮肤损伤愈合部位形成的增生性瘢痕常导致功能和美观缺陷。由于对瘢痕病因缺乏了解以及缺乏增生性瘢痕的动物模型，治疗方法受到一定限制。据报道，硅胶敷料在减少瘢痕增生和改善色差方面有积极效果，但其确切机制尚不清楚。
我们在瘢痕形成的动物模型中测试了硅胶黏附凝胶减少瘢痕增生的有效性。
将硅胶黏附凝胶应用于兔耳增生性瘢痕模型的瘢痕上。该模型中的瘢痕在注射类固醇和随着年龄增长时增生会减少，与人的情况相似，通过瘢痕抬高指数（SEI）来测量瘢痕，即瘢痕高度与正常皮肤高度的比值，读数大于1.0表示瘢痕隆起。
与未处理的瘢痕相比，硅胶凝胶应用4周后SEI显著降低（分别为1.15±0.15和1.71±0.33；P<.001）。与对照组相比，非硅胶对照敷料未改变SEI。治疗组之间在瘢痕细胞密度、炎症或基质组织方面未发现组织学差异；然而，超微结构观察显示，对照和非硅胶处理的瘢痕基底细胞中有大量空泡，而在未受伤皮肤或硅胶凝胶处理的瘢痕中未发现。硅胶凝胶和非硅胶敷料的水汽透过率相似，排除了瘢痕水合作用是硅胶敷料唯一作用机制的可能性。
我们在兔模型中的研究结果证明了硅胶凝胶治疗增生性瘢痕的有效性，并证实了该模型对进一步研究闭塞机制的有用性。（《美容外科杂志》2002年；22:147 - 153。）
