title: The prophylactic use of a topical scar gel containing extract of Allium cepae, allantoin, and heparin improves symptoms and appearance of cesarean-section scars compared with untreated scars.
abstract: BACKGROUND
  Abdominal Cesarean sections (C-sections) are frequently associated with an increased risk of excessive or unpleasant scarring. A topical scar gel containing extract of Allium cepae, allantoin and heparin (Contractubex®; Merz Pharmaceuticals GmbH, Germany), has shown efficacy in improving the appearance of various scar types.
  
  
  OBJECTIVE
  To investigate the efficacy of the topical scar gel, Contractubex, in the early treatment of C-section scars.
  
  
  METHODS
  A total of 61 females, aged ≥18 years, who had given birth by elective C-section for the first time within the last 5-10 days, were included in this prospective, randomized, single-center study. Patients were advised to apply the topical scar gel twice daily (treatment group), or received no treatment (control group). Efficacy was evaluated at 6 and 12 weeks after a baseline visit using the Patient and Observer Scar Assessment Scale (POSAS), a validated scar assessment tool comprised of a Patient Scale and an Observer Scale.
  
  
  RESULTS
  Analysis revealed a significant change in the POSAS Patient Scale total score, with a 14.2% improvement in the treatment group compared with a decline of similar magnitude (-14.8%) in the control group at week 6. Significant improvements were also seen for POSAS Patient Scale sub-items in the treatment group compared with the control group for scar color (13.6% vs -18.5%, respectively, P=0.0284), stiffness (12.5% vs -34.6%, respectively, P=0.0029), and irregularity (29.4% vs -46.2%, respectively, P=0.0140) after 6 weeks of treatment. No significant changes were observed for the POSAS Observer Scale total score or its subitems after treatment with the topical scar gel, although there was a strong overall trend in favor of the treatment group. No significant adverse events were observed during the study.
  
  
  CONCLUSIONS
  Contractubex represents an efficacious and well-tolerated preventative treatment that rapidly and significantly improves the color, stiffness and irregularity of C-section scars.
authors: Jorge
authors: J
authors: Ocampo-Candiani
authors: Osvaldo T
authors: OT
authors: Vázquez-Martínez
authors: José Luis
authors: JL
authors: Iglesias Benavides
authors: Kristin
authors: K
authors: Buske
authors: Annette
authors: A
authors: Lehn
authors: Clemens
authors: C
authors: Acker
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000481:Allantoin / Q000008:administration & dosage / Q000627:therapeutic use*; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D004338:Drug Combinations; D005260:Female; D005782:Gels; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D010936:Plant Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D005782:Gels; D010936:Plant Extracts; C053099:allantoin, heparin, onion extract drug combination; D000481:Allantoin; D006493:Heparin