Silicone Gel and Hypertrophic Scar Formation: A Literature Review

Abstract

Since 1982 a number of studies have investigated the use of silicone gel sheets in the prevention and reduction of hypertrophic scar formation. The statistical significance of several of these studies has been reduced by poor standardization of research methods, and the lack of a reliable and valid method of assessing hypertrophic scarring. When these studies are considered together, however, several clinically significant trends become apparent. The application of silicone gel appears to normalize the texture, colour, evaluation, and occurrence of subjective complaints (i.e., pain and pruritis) typically associated with hypertrophic scarring. These results are independent of the patient's age, method of attachment of the gel, or the location, age, or cause of the scar. The most appropriate treatment protocol for the application of silicone gel has yet to be determined. Current literature suggests that daily wearing tolerance be developed over the course of one to two weeks, the gel and scar be cleaned twice daily, and skin monitored regularly for signs of irritation. The optimal duration of treatment has not been established. Further research using standardized procedures and valid, reliable methods of measurement are required before this treatment can be ethically used to replace more established treatment techniques. However, the literature currently available would indicate that silicone gel may be an effective treatment technique for the prevention and reduction of hypertrophic scar formation following burn injury.