title: Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids.
abstract: BACKGROUND
  Trauma of various origins can induce a connective tissue disorder that leads to keloids. This condition has yet not been clearly distinguished from scars and hypertrophic scars. Only electronmicroscopic and biochemical data can help to do this. Among some more or less therapeutic approaches, the use of silicon (polydimethylsiloxane) plates, wrapped on the keloid surface, has been reported effective by some authors. These authors also demonstrated that it is not the mechanical pressure that is the mechanism of action, but a direct action on fibroblasts and a hyperhydration of subcutaneous tissue. The authors of this study conceived that the silicon plate may be able to improve the transdermal penetration of a compound such as vitamin E. This vitamin is capable of preserving some important morphologic and functional features of biological membranes by means of its phytilside chain of the molecule acting as a stabilizer of lysosomal membranes.
  
  
  METHODS
  Eighty patients of both sexes, aged between 18 and 63 years, who had hypertrophic scars and keloids, were admitted to the trial. The patients were randomized to two groups in a simple-blinded study. Group A: Forty patients whose scars have been covered with silicon plates with added vitamin E. Group B: Forty patients treated with simple silicone gel sheets. No pressure bandages were used, only tape fixing the sheet for 10 hours overnight. The trial lasted for 2 months. The results were recorded at 4 and 8 weeks, evaluating the improvement according to a Scott-Husskinson scale. For objective assessment photos were taken. The results were analyzed by the chi-square test.
  
  
  RESULTS
  At the end of the first month, group A had improved by more than 50% in 85% of cases, whereas the improvement in group B was 55% (P < 0.01). At the end of the second month, 95% of patients in group A had improved by 50%, whereas 75% had improved by 50% in group B (P < 0.05).
  
  
  CONCLUSIONS
  Vitamin E added to the silicon plate scored better than the simple silicon plate at the end of both periods. We have reported the successful combined action of vitamin E and silicone gel sheets in scar treatment, especially in the short-term prophylaxis of hypertrophic scars or keloids.
authors.affiliation: Department of Surgical Semeiotics, University of Modena, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Palmieri
authors.forename: G
authors.initials: G
authors.lastname: Gozzi
authors.forename: G
authors.initials: G
authors.lastname: Palmieri
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D017439:Cicatrix, Hypertrophic / Q000473:pathology / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007627:Keloid / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012828:Silicones / Q000008:administration & dosage* / Q000627:therapeutic use; D012869:Skin Absorption / Q000187:drug effects; D016896:Treatment Outcome; D014810:Vitamin E / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D012828:Silicones; D014810:Vitamin E