The use of silicon gel for treating children's burn scars in Saudi Arabia: a case study

Abstract

This case study is presented to illustrate the effectiveness of silicon gel as an important option in burn scar treatment and to provide treatment guidelines that address cultural, clinical and patient compliance issues in Saudi Arabia. The case study involves an 18-month-old child whose burn scar was treated for a period of 15 months with silicon gel. The Vancouver Burn Scar Scale assessment (Baryza and Baryza, 1995), used to track progress across the duration of treatment, reflected an improvement in the scar as the composite score changed from 9 to 2. Strategies for problem solving and addressing needs unique to the environment of Saudi Arabia were also developed over the treatment period. The findings of this case study indicate that silicon gel may be a superior treatment option under certain circumstances. Further research with a wider sample is indicated, given the high incidence of childhood burn injuries in Saudi Arabia.

A Review of the Biologic Effects, Clinical Efficacy, and Safety of Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and Management

“…98,100 These adverse effects can be avoided by building up wearing time, beginning with approximately 2 hours per day and gradually increasing to 12 to 24 hours per day as tolerated. 7,[103][104][105] The paucity of adverse events reported in clinical trials of silicone gel sheeting suggests that the presence of silicon in the skin does not contribute to the incidence of adverse events. Silicone elastomer sheeting products are safe and have minimal potential to cause harm, as substantiated by the absence of case reports in the literature describing serious adverse effects.…”

“…114 Pressure therapy is expensive because pressure garments are custom-made and must be replaced as they wear out and a patient grows or loses or gains weight. 103,104 Pressure garments can also be uncomfortable and patient compliance is poor. 102,108,115 Radiotherapy is controversial because of the possibility of carcinogenesis.…”

“…Dry skin was treated with application of moisturizer to the scar and episodes of malodorous gel sheets were resolved with institution of better hygiene by washing the scar and gel sheet more frequently with mild soap and water 98,100 . These adverse effects can be avoided by building up wearing time, beginning with approximately 2 hours per day and gradually increasing to 12 to 24 hours per day as tolerated 7,103–105 …”

“…Silicone elastomer sheeting products are safe and have minimal potential to cause harm, as substantiated by the absence of case reports in the literature describing serious adverse effects. If adverse effects do occur, they can be managed by temporary interruption of therapy, reduction of wearing time, and instruction in better hygiene 7,103–105 …”

“…Injection of corticosteroids into the scar can cause significant pain, skin atrophy, depigmentation, and telangiectasias 114 . Pressure therapy is expensive because pressure garments are custom‐made and must be replaced as they wear out and a patient grows or loses or gains weight 103,104 . Pressure garments can also be uncomfortable and patient compliance is poor 102,108,115 .…”