液体硅胶凝胶在预防和治疗增生性瘢痕中的应用：一项系统评价和荟萃分析。
The use of fluid silicone gels in the prevention and treatment of hypertrophic scars: a systematic review and meta-analysis.
作者信息
De Decker Ignace, Hoeksema Henk, Verbelen Jozef, Vanlerberghe Els, De Coninck Petra, Speeckaert Marijn M, Blondeel Phillip, Monstrey Stan, Claes Karel E Y
机构信息
Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium.
Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Department of Plastic Surgery, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium.
出版信息
Burns. 2022 May;48(3):491-509. doi: 10.1016/j.burns.2022.03.004. Epub 2022 Mar 17.
BACKGROUND
Silicone products, either as a sheet or in fluid form, are universally considered as the first line therapy in the prevention and treatment of hypertrophic scars and keloids. However, the study results have been questioned by different authors and there has never been a large systematic synopsis published on the efficacy of fluid silicone gels. This systematic review aims to elucidate the available evidence of the results obtained by fluid silicone gels and present a complete and comprehensive overview of the available literature as well as a meta-analysis of the pooled data.
METHODS
A systematic search for articles concerning the use of silicone gel in the treatment and prevention of scars was performed on 3 different databases (Pubmed, Embase and Cochrane library) according to the PRISMA statement. Only RCT's were included. Qualitative assessment was done by 2 separate reviewers using the Cochrane risk of bias (RoB 2) assessment tool. Revman 5.4.1 software was used for meta-analysis.
RESULTS
The search yielded 507 articles. Two articles were identified through other sources. After deduplication and removal of ineligible records, 340 records were screened on title and abstract. Full text screening was done for 23 articles and ultimately 18 articles were included. A meta-analysis comparing fluid silicone gel to no treatment or placebo gels was conducted.
CONCLUSION
Studies on the effects of liquid silicone gels on hypertrophic scars are numerous and this systematic review shows that the use of liquid silicone gels is associated with both a prophylactic and a curative effect on scars. However, a considerable amount of the available 'high evidence' trials are at a high risk for bias and it is uncertain whether or not the effects of silicone gels are comparable to silicone sheets and if the additional components present in many silicone gels are partially responsible for their scar improving capacity.
背景
硅酮产品，无论是片状还是液体形式，普遍被视为预防和治疗增生性瘢痕和瘢痕疙瘩的一线疗法。然而，不同作者对研究结果提出了质疑，并且从未有关于液体硅酮凝胶疗效的大型系统性综述发表。本系统评价旨在阐明液体硅酮凝胶所获结果的现有证据，并对现有文献进行完整、全面的综述以及对汇总数据进行荟萃分析。
方法
根据PRISMA声明，在3个不同数据库（PubMed、Embase和Cochrane图书馆）中对有关硅酮凝胶用于治疗和预防瘢痕的文章进行系统检索。仅纳入随机对照试验。由2名独立评审员使用Cochrane偏倚风险（RoB 2）评估工具进行定性评估。使用Revman 5.4.1软件进行荟萃分析。
结果
检索共获得507篇文章。通过其他来源确定了2篇文章。在进行重复数据删除和排除不合格记录后，对340条记录进行了标题和摘要筛选。对23篇文章进行了全文筛选，最终纳入18篇文章。对液体硅酮凝胶与不治疗或安慰剂凝胶进行了荟萃分析。
结论
关于液体硅酮凝胶对增生性瘢痕影响的研究众多，本系统评价表明，使用液体硅酮凝胶对瘢痕具有预防和治疗作用。然而，大量现有的“高证据”试验存在较高的偏倚风险，并且不确定硅酮凝胶的效果是否与硅酮片相当，以及许多硅酮凝胶中存在的其他成分是否部分促成了它们改善瘢痕的能力。
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