Papers of The 7th Japan Scar Workshop

7. Evaluation of the effect of preventing postoperative hypertrophic scars by prophylactic use of soft silicone gel sheet

Mamiko Tosa1, Masahiro Murakami1, Hiko Hyakusoku2
1:Department of Plastic and Reconstructive Surgery, Nippon Medical School Musashikosugi-Hospital, Kawasaki, Japan
2:Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan

Purpose: Hypertrophic scars and keloids often appear at the site of incision after median cesarean section. Topical silicone gel sheeting has been used for more than 30 years to treat hypertrophic scars and keloids. The purpose of this study was to determine whether topical soft silicone gel sheeting can be used to prevent hypertrophic scar and keloid arising from median cesarean section.
Methods: In a randomized prospective study, patients undergoing repeated cesarean section were stratified into two groups: those with no history of abnormal scarring after the first cesarean section (low-risk group) and those with a history of abnormal scarring after the first cesarean section (high-risk group). After the procedure, patients within each group were randomized to receive either routine postoperative care or topical soft silicone gel sheeting and were followed up for 6 months.
Results: In the low-risk group, the incidences of hypertrophic scar were 8% in patients who received routine postoperative care and 0% in those who received topical soft silicone gel sheeting. In the high-risk group, these incidences were 100% and 73.9% respectively. At the 6 months follow up, all patients were free of keloids.
Discussion/Conclusion: Topical soft silicone gel sheeting appears to be useful in the prevention of hypertrophic scar in patients undergoing repeated median cesarean section.
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