Static-Electric Field Induction by a Silicone Cushion for the Treatment of Hypertrophic and Keloid Scars

Abstract

Silicone gel and silicone occlusive sheeting are widely used at present for the treatment of hypertrophic and keloid scars, without any scientific explanation as to their mode of action. In a recent paper the possibility was raised that static electricity generated by friction-activated silicone sheeting could be the reason for this effect, and that it can, with time, cause involution of hypertrophic and keloid scars. The objective of this study was to test this hypothesis and to observe whether a continuous and also an increased negatively charged static-electric field will shorten the treatment period. A device to implement these requirements gradually evolved over a 5-year period. A number of prototypes were tested until the final product was attained. Some of the patients in this study were treated initially with a silicone sponge inserted in the cushion. Later this version was changed to the final design described herein. A silicone cushion was developed with the purpose of increasing a negative static-electric charge to accelerate the regression process. The cushion is custom-made using a silicone occlusive sheeting envelope of 0.75-mm thickness, which does not deteriorate with use, and is partially filled with high viscosity silicone oil. Its edges are sealed, and its size is designed to extend a little beyond the scarred area. Static electricity readings, generated by activating the cushion by pumping action with the fingers, stretching or deforming the cushion, are invariably much higher when compared with those obtained with silicone occlusive sheeting and silicone gel sheeting. The interaction between the negatively charged ions of the cushion and the ionic charges of the tissue fluids may be the critical factor in achieving hypertrophic and keloid scars involution. Of the 30 patients enrolled in the study, 3 patients dropped out. Treatment with the silicone cushions yielded 63.3 percent cessation of itching and burning followed by pallor and flattening of the scar, some markedly so, over a few weeks to 6-month period. An additional 26.6 percent had their scars resolved in up to 12 months of treatment. Good contact of the cushion over the scar has been shown to be important in this clinical trial, and much creativity is needed for making elastic strap bindings that ensure this contact. The clinical trials extended over a 12-month period. Ten patients (33.3 percent) who had recalcitrant scars with little response to the use of the silicone cushion were given intralesional corticosteroid injections, in addition to the continued use of the cushion, resulting in a fairly rapid resolution of these scars over a period of months to a year.

The Use of Silicone Adhesives for Scar Reduction

“…This static electricity is thought to aid the alignment of collagen cells, thus resulting in the involution of raised scars. 25,27,28 The findings surrounding therapeutic mechanisms support the hypothesis that there are multiple combined processes by which SGS create homeostasis of the skin's barrier function beyond straightforward hydration and occlusion of the scar site. Many suggested factors are regarded as having a significant influence in the overall efficacy of SGS, although some lack thorough clinical support.…”

Silicone occlusive treatment of hypertrophic scar in the rabbit model

“…16,19,20 The generation of a charge difference at the skin surface (ie, static electricity) has also been proposed as a possible mechanism by which silicone sheeting affects scar resolution. 21 However, the most prevalent theory has focused on the ability of silicone occlusive dressings to increase hydration of the stratum corneum. 22 It has been suggested that silicone ointment may also be effective, 23 as well as occlusive oil without any silicone product.…”

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

“…Various mechanisms have been proposed as possible modes of action for silicone-based agents and corticosteroids in the wound healing processes including: 1) an increased temperature or oxygen tension increasing collagenase activity and leading to collagen breakdown shrinking the scars [3,7], 2) occlusion and hydration of wounds [7,13]; reduction in transepidermal water loss decreases stimulation of keratinocytes which stops cytokine production [13], and 3) polarization of the scar tissue caused by a negative static charge between silicone and skin [14] and the modulation of growth factors [9,15,16].…”