Clugston P A, Vistnes M D, Perry L C, Maxwell G P, Fisher J
Institute for Aesthetic and Reconstructive Surgery, Baptist Hospital and Surgical Research Laboratory, Inc, Nashville, TN.
Ann Plast Surg. 1995 Jan;34(1):12-5. doi: 10.1097/00000637-199501000-00003.
Topical silicone-gel sheeting has been shown to be beneficial in the treatment of established hypertrophic and keloid scars. Certain individuals and incisions in specific body sites appear to be at increased risk for the development of such scars. A simple, inexpensive, and preventive treatment in these individuals at increased risk could potentially minimize the extended period of pressure therapy and repeated steroid injections that are often required to optimize outcome. However, the effects of applying silicone-gel sheeting in the immediate postoperative period as a preventive measure have not been investigated to date. Because silicone-gel sheeting influences the remodeling and maturation phase of collagen formation, we believed it prudent to determine whether silicone-gel sheeting had any deleterious effect on early wound healing, as demonstrated by in vivo biomechanical testing of wound strength and histological assessment. To investigate the potential effects of silicone-gel sheeting on acute wound healing and its possible application for prevention of hypertrophic scars, a study was designed in the hairless guinea pig. In phase 1 of the study, bilateral dorsolateral incisions were made, allowing each guinea pig to serve as its own control. One wound was dressed with silicone-gel sheeting, and the control site was dressed with Nu-gauze dressing. Wounds were then assessed visually and with in vivo biomechanical analysis of wound strength at days 3, 5, and 7 postoperatively (n = 7 per group). Phase 2 of the study compared identical dressings in a similar animal model using a single dorsal midline incision, in which alternate halves of each wound served as the control.(ABSTRACT TRUNCATED AT 250 WORDS)
外用硅胶片已被证明对已形成的增生性瘢痕和瘢痕疙瘩的治疗有益。某些个体以及特定身体部位的切口似乎发生此类瘢痕的风险更高。对于这些风险增加的个体,一种简单、廉价的预防性治疗可能会减少为优化治疗效果而通常需要的长时间压力疗法和反复注射类固醇的情况。然而,迄今为止,尚未研究在术后即刻应用硅胶片作为预防措施的效果。由于硅胶片会影响胶原蛋白形成的重塑和成熟阶段,我们认为通过伤口强度的体内生物力学测试和组织学评估来确定硅胶片对早期伤口愈合是否有任何有害影响是谨慎之举。为了研究硅胶片对急性伤口愈合的潜在影响及其预防增生性瘢痕的可能应用,我们在无毛豚鼠身上设计了一项研究。在研究的第一阶段,进行双侧背外侧切口,使每只豚鼠作为自身对照。一个伤口用硅胶片包扎,对照部位用Nu - 纱布包扎。然后在术后第3、5和7天对伤口进行视觉评估以及伤口强度的体内生物力学分析(每组n = 7)。研究的第二阶段在类似的动物模型中使用单一背部中线切口比较相同的敷料,其中每个伤口的交替两半作为对照。(摘要截短为250字)