Department of Chemical and Materials Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan.
Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Sci Rep. 2018 May 9;8(1):7422. doi: 10.1038/s41598-018-25697-x.
Upper lip scars are at risk of hypertrophy. Our center therefore uses microporous tape and silicone sheeting for postoperative scar care following cleft lip repair. However, some babies have previously ingested their silicone sheeting, which has the potential for respiratory compromise or gastrointestinal obstruction. Self-dry silicone gel is reportedly also effective for preventing hypertrophic scars. Hence, we sought to test whether silicone gel, which cannot be ingested whole, might be non-inferior to silicone sheeting for controlling against upper lip scar hypertrophy. This was a mixed prospective and retrospective case-controlled clinical trial involving patients undergoing unilateral cleft lip repair, 29 of whom received standard postoperative silicone sheeting (control group) and another 33 age-matched consecutive patients who received self-dry silicone instead. The Vancouver scar scale, visual analogue scale and photographically assessed scar width assessments were the same in both groups at six months after surgery. In conclusion, silicone gel appears to be non-inferior to silicone sheeting for postoperative care of upper lip scars as judged by scar quality at six months, but silicone sheeting has the safety disadvantage that it can be swallowed whole by babies. It is thus recommended that silicone gel be used for upper lip scar management in babies.
上唇瘢痕有发生增生的风险。因此，我们中心在唇裂修复术后使用微孔胶带和硅酮片进行瘢痕护理。但是，有些婴儿曾吞食过硅酮片，这可能会导致呼吸窘迫或胃肠道梗阻。据报道，自干型硅凝胶也可有效预防增生性瘢痕。因此，我们试图验证不能被整体吞食的硅凝胶是否在控制上唇瘢痕增生方面不劣于硅酮片。这是一项混合前瞻性和回顾性病例对照临床试验，涉及接受单侧唇裂修复术的患者，其中 29 例接受标准术后硅酮片（对照组），另有 33 例年龄匹配的连续患者接受自干型硅酮治疗。术后 6 个月时，两组的温哥华瘢痕量表、视觉模拟量表和照片评估的瘢痕宽度评估结果相同。总之，硅凝胶在术后 6 个月时的瘢痕质量方面似乎不劣于硅酮片，但硅酮片存在安全隐患，即婴儿可能会将其整个吞下。因此，建议在婴儿的上唇瘢痕管理中使用硅凝胶。
