Comparison of the effectiveness of topical silicone gel and corticosteroid cream on the pfannenstiel scar prevention — a randomized controlled trial

Abstract

Objectives: To compare the effects of topical silicone gel and corticosteroid cream for preventing hypertrophic scar and keloid formation following Pfannenstiel incisions. Material and methods:Fifty patients operated for benign gynecological diseases through primary Pfannenstiel incision were included. The wounds were randomly allocated to the treatment and control arms. In the treatment arm, the wounds were divided into two halves; one was treated with silicone gel and the other with methylprednisolone cream. No treatment was administered to the control group. Scars using the modified Vancouver Scar Scale (MVSS), patient satisfaction, and side effects were evaluated before and after (3 rd month when treatment discontinued and 6 th month) the treatment.Results: Thirty-nine patients (21 patients in the treatment group and 18 patients in the control group) completed the study. Intragroup comparisons of the 3 rd month and 6 th month scores of the MVSS revealed that the scores of all parameters (height, pigmentation, vascularity, pliability, and total MVSS score) significantly decreased at the 6 th month evaluation as compared with the 3 rd month evaluation in all groups (control, silicone, and methylprednisolone groups). Multiple group comparisons at the 6 th month revealed that the most prominent improvements occurred in the methylprednisolone group in all MVSS parameters as compared with the control group and in the height, vascularity, and pigmentation parameters as compared with the silicone group. No side effects were experienced by the patients with either treatment and patient satisfaction was higher in the methylprednisolone group. Conclusion:The use of topical methylprednisolone cream in fresh wounds at the postoperative early period appears to be promising.

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“…Existem também os tratamentos não invasivos, sendo os preferíveis para início do tratamento (MESECI et al, 2017). Dessa maneira, MESECI et al (2017) desenvolveu um estudo clínico para comparar a eficácia do gel de silicone e corticosteroide na prevenção de queloide em incisões de Pfannnestiel.…”

Efficacy of topical silicone gel in scar management: A systematic review and meta‐analysis of randomised controlled trials

“…In addition, five RCTs using VSS did not report results in the form of mean ± standard deviation and were excluded . Finally, six RCTs with a total of 375 patients were included (Figure ). The baseline characteristics of the six studies were shown in Table .…”

Angiotensin‐converting enzyme inhibitor and angiotensin II type 1 receptor blocker: Potential agents to reduce post‐surgical scar formation in humans

“…If oral ACEI/ARB antihypertensive drugs are used in scar patients without hypertension solely to reduce scarring, they may cause undesirable side effects, such as hypotension. What is more, non‐invasive, painless and convenient treatments often enhance patient compliance 22 . So, if they can be used topically, the side effects of oral administration can be greatly reduced.…”

“…What is more, non-invasive, painless and convenient treatments often enhance patient compliance. 22 So, if they can be used topically, the side effects of oral administration can be greatly reduced. To this end, our previous work explored and proved that the ACE participating in scar formation was derived from both bone marrow and local skin tissue, 23 indicating that inhabiting any one of the two ACE sources could probably be beneficial.…”