title: No efficacy for silicone gel sheeting in prevention of abnormal scar formation in children with cancer: a randomized controlled trial.
abstract: BACKGROUND
  Placement of a totally implantable venous access device in children with cancer often leads to hypertrophic scars after its removal. This study investigates whether the use of silicone gel sheets has a beneficial effect on scar outcome in children with cancer.
  
  
  METHODS
  In a three-arm randomized controlled trial, the effects of use of silicone gel sheets for 2 and 6 months were assessed and compared with no intervention in children with cancer after removal of the totally implantable venous access device. Silicone gel sheets were first administered 14 days after surgery. The 1-year follow-up included measurements at seven time points. Next to scar size assessment, the modified Vancouver Scar Scale was used to assess scar outcome.
  
  
  RESULTS
  Thirty-six children participated. For hypertrophy, no significant differences were found between the two intervention groups and the control group. However, at 1-year follow-up, the 2-month application group showed significantly smaller scars compared with the group receiving silicone gel sheet treatment for 6 months (p = 0.04), but not when compared with the control group (p = 0.22). Longitudinal multilevel analyses could not confirm these findings and showed no significant intervention effects on both outcomes.
  
  
  CONCLUSIONS
  This study provides no strong evidence to support the use of silicone gel sheets after totally implantable venous access device removal in children with cancer. There seems to be a small benefit for scar width with application for 2 months. However, for hypertrophy, the scar outcome shows no significant difference between the control group and the 2-month and 6-month treatment groups.
authors: Amsterdam, The Netherlands From the Division of Pediatric Oncology/Hematology, Department of Pediatrics, the Department of Plastic, Reconstructive and Hand Surgery, Pediatric Surgical Center Amsterdam, VU University Medical Center; and the Department of Pediatric Oncology, Emma Children's Hospital, Academic Medical Centre.
authors: Katja I
authors: KI
authors: Braam
authors: Esmee C M
authors: ECM
authors: Kooijmans
authors: Eline
authors: E
authors: van Dulmen-den Broeder
authors: Margreet A
authors: MA
authors: Veening
authors: Antoinette Y N
authors: AYN
authors: Schouten-van Meeteren
authors: Pauline D H M
authors: PDHM
authors: Verhaegen
authors: Gertjan J L
authors: GJL
authors: Kaspers
authors: Frank B
authors: FB
authors: Niessen
authors: Hugo A
authors: HA
authors: Heij
mesh_terms: D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002921:Cicatrix / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D020034:Silicone Gels
chemical_list: D020034:Silicone Gels