Rhee Suk-Hyun, Koh Sung-Hoon, Lee Dong-Won, Park Beyoung-Yun, Kim Yong-Oock
Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, South Korea.
J Craniofac Surg. 2010 May;21(3):706-10. doi: 10.1097/SCS.0b013e3181d83fec.
Scars on exposed areas are a major concern among Asian populations because of their conspicuousness. Size, color, or whether the scar is hypopigmented or hyperpigmented matters little. Silicone gel is well known for the prevention and induction of better maturation of hypertrophic and keloid scars. However, its aesthetic effect on normal surgical scars has not been considered.
Clinical evaluation of scars was performed in 40 patients. All the 40 patients underwent clean and minor surgery of the exposed area, such as scar revision, by 1 plastic surgeon. Twenty of the 40 patients did not apply any adjunctive material for scar management and were grouped as the control. The other 20 patients applied a silicone gel sheet for 12 hours a day for 3 months. Three assessment criteria, pigmentation, vascularity, and height, were evaluated by photographic assessment of the scars at 2 weeks, 1 month, and 3 months postoperatively and scored by 3 plastic surgeons. The Wilcoxon rank sum test was used to verify any significant differences in the previously mentioned 3 parameters between the 2 groups and parameter scores at each follow-up period.
Two patients were excluded from the study because of the development of rashes on the areas covered by the silicone gel sheet. There was no statistical significance between the groups at postoperative 2 weeks and 1 month in pigmentation and redness. For evaluation of height, there was statistical significance (P = 0.024) at postoperative 1 month. However, there were statistically significant differences in all the assessment criteria at postoperative 3 months between the groups: pigmentation, P = 0.0002; vascularity, P = 0.0002; and height, P < 0.0001.
The silicone gel sheet has a favorable aesthetical effect for normally created surgical scars in the Asians. Its application can reduce the conspicuousness of scars more rapidly than without.
由于显眼性，暴露部位的瘢痕是亚洲人群主要关注的问题。瘢痕的大小、颜色，或是否色素减退或色素沉着并不重要。硅胶凝胶因预防和促使增生性瘢痕和瘢痕疙瘩更好地成熟而闻名。然而，其对正常手术瘢痕的美学效果尚未得到考量。
对40例患者的瘢痕进行临床评估。这40例患者均由1名整形外科医生进行了暴露部位的清洁小手术，如瘢痕修复。40例患者中有20例未使用任何辅助材料进行瘢痕处理，被归为对照组。另外20例患者每天使用硅胶凝胶片12小时，共3个月。通过对术后2周、1个月和3个月的瘢痕进行摄影评估，由3名整形外科医生对色素沉着、血管分布和高度这三项评估标准进行评估并评分。采用Wilcoxon秩和检验来验证两组之间上述三个参数以及各随访期参数评分的任何显著差异。
2例患者因硅胶凝胶片覆盖区域出现皮疹而被排除在研究之外。两组在术后2周和1个月时色素沉着和发红方面无统计学意义。在评估高度方面，术后1个月有统计学意义（P = 0.024）。然而，两组在术后3个月时所有评估标准均存在统计学显著差异：色素沉着，P = 0.0002；血管分布，P = 0.0002；高度，P < 0.0001。
硅胶凝胶片对亚洲人正常形成的手术瘢痕具有良好的美学效果。其应用比不使用能更快降低瘢痕的显眼性。
