Comparison of a silicone gel-filled cushion and silicon gel sheeting for the treatment of hypertrophic or keloid scars

BACKGROUND. The exact mechanisms of action responsible for the effectiveness of silicone gel dressings are unknown, although it has been proposed that static electricity generated by friction could be the reason for their anti-scarring effects. OBJECTIVE. We compared the efficacy of a cushion of silicone filled with liquid silicone gel reported to induce greater negative static-electric charge with silicone gel sheeting in the treatment of hypertrophic and keloid scars. METHODS. The size, volume, symptoms (tenderness and itching), and signs (color and induration) of hypertrophic (10 patients) or keloid scars (22 patients) were measured at baseline at 16 weeks following use of either the silicone gel cushion or silicone gel sheeting, as determined by random assignment. RESULTS. Both the silicone gel cushion and the silicone gel sheeting treatments were effective in decreasing scar volume, 53.0% and 36.3%, respectively. The percentages of keloids and hypertrophic scars benefiting from the silicone cushion and the silicone sheeting were similar with respect to reduction in tenderness (36.3% vs 33.3%), itching (45.5% vs 33.3%), and redness (0.1% vs 0.1%), and in the degree of softening (45.5 vs 25.0%). CONCLUSIONS. Both the silicone gel cushion and the silicone gel sheeting treatments were effective in the treatment of keloids and hypertrophic scars, although no statistically significant differences were found between the two treatment modalities.