Effect of silicone gel versus Contractubex or corticosteroid phonophoresis for post-burn hypertrophic scars: a single-blind randomized controlled trial

Abstract

Introduction. Hypertrophic scars and keloids are physically and mentally disturbing, and can cause pain and itching. Various treatment is utilized to diminish or counteract scarring. The purpose of this study was to compare the effect of silicone gel, Contractubex gel, and corticosteroid phonophoresis for post-burn hypertrophic scars. Methods. A prospective, single-blind, randomized, controlled study with pretest-posttest design was performed; 45 patients aged 20-45 years with hypertrophic scars, 2-4 months post thermal burn were involved. They were randomly assigned to 3 groups: group A (15 patients, 8 males and 7 females) received phonophoresis with silicone gel, group B (15 patients, 8 males and 7 females) received phonophoresis with Contractubex gel, and group C (15 patients, 9 males and 6 females) received corticosteroid phonophoresis. All treatment interventions were applied at the frequency of 3 sessions/week for 24 weeks. The participants were recruited from the Kasr El-Ani hospital outpatient clinic to be treated in the outpatient clinic, Faculty of Physical Therapy, Cairo University. Results. outcome measures were taken with the modified Vancouver Scar Scale (VSS) before the treatment, and 12 and 24 weeks after the intervention. The comparison among the 3 groups revealed a highly significant decrease in modified VSS total score in group A compared with group B and group C (p < 0.01), as well as in group B compared with group C (p < 0.001). Conclusions. Silicone gel phonophoresis is a more effective method for post-burn hypertrophic scar management than Contractubex gel phonophoresis or corticosteroid phonophoresis.

Management of hypertrophic scars in adults: A systematic review and meta‐analysis

“…When topical silicone gel was compared with sheets, both were equally effective in lowering VSS scores (54% reduction for gel vs 52% reduction for sheets) and superior to onion extract gel, which yielded a 35% decrease in overall VSS score 35 . Wahba and colleagues 28 also showed a greater reduction in VSS scores in patients treated with silicone and phonophoresis vs those treated with onion extract and phonophoresis (62% vs 42% decrease in overall VSS score). However, silicone gel and onion extract gel were equally effective in reducing overall VSS and other scale scores 39 …”

“…The studies were subdivided into those which performed an intention‐to‐treat (ITT) analysis ( n = 15) and those which performed a per‐protocol analysis ( n = 19). Of the 15 studies with ITT analysis, only one study 39 was associated with a low risk of bias, while 5 18,23,28,30,40 and 9 17,20,25,29,31,33,35,37 studies were associated with moderate and high risk of bias, respectively.…”

“…In a half‐scar study, silicone gel had a shorter time to improvement (3.9 days vs 6.8 days, P < 0.05) and was more favoured by patients (2 of 14 patients favoured TAC, 11 of 14 patients favoured silicone, and 1 patient had no preference) compared with TAC 27 . Furthermore, silicone led to greater improvement in VSS compared with TAC (62% vs 25%, P = 0.0001) 28 . However, another study found TAC and silicone gel sheeting resulted in comparable improvements in VSS scores 29 …”

“…27 Furthermore, silicone led to greater improvement in VSS compared with TAC (62% vs 25%, P = 0.0001). 28 However, another study found TAC and silicone gel sheeting resulted in comparable improvements in VSS scores. 29 Botulinum toxin type A (BTX-A), pentoxifylline and EXC001 (an antisense oligonucleotide targeting skin tissue growth factor) were evaluated in one study each.…”

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

“…In addition to combined treatment, we could also use methods like ultrasound or nanotechnology to improve the efficacy of single therapy. Wahba et al reported silicone gel phonophoresis outperformed steroid or onion extract phonophoresis for treating post‐burn hypertrophic scars . In a word, silicone gel as well as other silicone‐based products could serve as the “cornerstone” for various combined scar treatment, which is the future trend for scar management.…”