title: Keratin gel improves poor scarring following median sternotomy.
abstract: BACKGROUND
  Linear hypertrophic scarring is a common surgical problem that can be difficult to manage. This article evaluates median sternotomy wounds that have often been reported to scar poorly resulting in hypertrophic scar formation.
  
  
  METHODS
  This study is a single-blinded, open-labelled pilot study of 20 patients using keratin gel as the intervention and aqueous cream as the control, which are each applied to a different half of the wound daily over 6 months. We use the Patient and Observer Scar Assessment Scale (POSAS) and the Manchester Scar Score (MSS) to assess the scarring.
  
  
  RESULTS
  At the 6-month assessment the MSS, patient-POSAS and observer-POSAS were 12.00, 16.70 and 15.00 in the treatment half and 12.58, 17.85 and 16.55 in the control half respectively. Overall, we found that there was a decrease in all score scales after 6 months (P = 0.005). Furthermore, in the subset of patients with poor scarring, decreases in the MSS, patient-POSAS and observer-POSAS were statistically significant (P = 0.025, <0.01 and 0.01) with scores of 12.22, 17.33 and 15.33 in the treatment half and 14.22, 23.67 and 22.33 in the control half respectively.
  
  
  CONCLUSIONS
  In patients who scar more poorly than average, there were significant improvements in scarring. This demonstrates a simple, well-tolerated intervention that reduces problematic scarring following surgery.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: N Hamesh
authors.initials: NH
authors.lastname: Jina
authors.forename: Clive
authors.initials: C
authors.lastname: Marsh
authors.forename: Martin
authors.initials: M
authors.lastname: Than
authors.forename: Harsh
authors.initials: H
authors.lastname: Singh
authors.forename: Sharon
authors.initials: S
authors.lastname: Cassidy
authors.forename: Jeremy
authors.initials: J
authors.lastname: Simcock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000517:prevention & control*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D006801:Humans; D007633:Keratins / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D016037:Single-Blind Method; D056346:Sternotomy; D014945:Wound Healing; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D007633:Keratins
keywords: cosmesis; scarring