International Advisory Panel on Scar Management consisting of leading leading dermatologists and plastic surgeons, led by Thomas A. Mustoe, M.D. (Division of Plastic and Reconstructive Surgery, Northwestern University School of Medicine) compiled International Clinical Recommendations on Scar Management which provide evidence-based recommendations on prevention and treatment of abnormal scarring and, where studies are insufficient, consensus on best practice.
Some of the recommendations for scar treatment and prevention related to silicone based products like Strataderm include:
Primary role for silicone: “Recommendations support a move to a more evidence-based approach in scar management. This approach highlights a primary role for silicone gel sheeting and intralesional corticosteroids in the management of a wide variety of abnormal scars.”
Effective Treatment: “The efficacy of two scar management techniques, silicone gel sheeting and injected corticosteroids, has been demonstrated in randomized, controlled trials.”
Effective Treatment: “Good evidence of [silicone’s] efficacy and silicone gel sheeting has now become standard care for plastic surgeons.”
Combination Treatment in Keloid prevention: “Surgical excision of hypertrophic scars or keloids is a common management option when used in combination with steroids and/or silicone gel sheeting.”
Safe and Effective: “Results from at least eight randomized, controlled trials and a meta-study of 27 trials demonstrate that silicone gel sheeting is a safe and effective management option for hypertrophic scars and keloids.”
Ideal for Children: “Silicone gel sheeting may be especially useful in children and others who cannot tolerate the pain of other management procedures.”
Scar Prevention: “Silicone gel sheeting, which should be considered as first-line prophylaxis. Use of silicone gel sheeting should begin soon after surgical closure, when the incision has fully epithelialized, and be continued for at least 1 month.”
Linear hypertrophic (surgical/traumatic) scars (red, raised). “Silicone gel sheeting should be used as first-line therapy.”
Widespread burn hypertrophic scars (red/raised). “Widespread burn scars should be treated with first-line therapy of silicone gel sheeting and pressure garments, although there remains limited significant evidence for the efficacy of pressure garments.”
Minor keloids. “The consensus view from the literature and the authors is that first-line therapy for most minor keloids is a combination of silicone gel sheeting and intralesional corticosteroids.”
Source: Plast Reconstr Surg. 2002 Aug;110(2):560-71. International clinical recommendations on scar management, Mustoe TA, Cooter RD, Gold MH, Hobbs FD, Ramelet AA, Shakespeare PG, Stella M, Téot L, Wood FM, Ziegler UE; International Advisory Panel on Scar Management.
April 23, 2010 at 9:46 am
[…] 2002, an International Advisory Panel on Scar Management published Clinical Recommendations on Scar Management, based on a qualitative overview of 300 published references and expert consensus on best […]
May 3, 2010 at 8:39 pm
[…] based products, like Strataderm silicone gel, have been recommended by International clinical recommendations on scar management and have become the standard care for plastic surgeons when it comes to scar treatment and […]
May 17, 2010 at 9:39 am
[…] prevent abnormal scar tissue International Clinical Recommendations on Scar Management recommend treatment of widespread burn scars with a first-line therapy of silicone gel sheeting and […]
June 15, 2010 at 8:27 am
[…] keloid scars are difficult to treat, combination treatments seem to be the most effective. International Clinical Recommendations on Scar Management highlight a primary role for silicone and intralesional corticosteroids in the management of a wide […]
July 1, 2010 at 4:18 pm
To say the paper by the International Clinical recommendations on Scar management refers to “silicone based products like Strataderm” is misleading at best. Silicone is ceratinly not a homogeneous category as the silcone scar cream and gel companies would lead us to believe. It is scientific and intellectual dishonesty to suggest that silcione oils and gels can make the same claims as the studies that verify silicone sheeting is 90% effective in the management of problems scars can
September 23, 2010 at 5:22 pm
Studies suggest that silicone gel (but not silicone oil) is as effective as silicone gel sheeting while easier and simpler to use which leads to greater patient compliance.
Example 1, Thomas Mustoe, a leading scar management expert: A new formulation of silicone gel applied from a tube forms a thin flexible sheet over the
newly epithelialized wound or more mature scar. Results from clinical trials and clinical experience suggest that silicone gel is equivalent in efficacy to traditional silicone gel sheeting but easier to use. (Thomas A. Mustoe, Evolution of Silicone Therapy and Mechanism of Action in Scar Management, Aesth Plast Surg (2008) 32:82–92) http://www.springerlink.com/content/a084p1m4q1385109/
Another example of scuh a study: “The effect of a thin layer of semiliquid silicone gel will be similar to that of a sheet covering, except, that no maceration occurs” http://journals.lww.com/plasreconsurg/Abstract/2005/09150/A_Randomized,_Placebo_Controlled,_Double_Blind,.14.aspx
March 14, 2013 at 5:11 pm
Silicone gels and ointments can cause foriegn body reactions such as granulomas , siliconoma , rounded vacuols body giantcells, ulcerations chronic cellulitus distant migration of materials when injected. Being that keloids and hypertrophic scars have a completely compromised stratum corneum these topical silocone scar gels can freely enter the body as if they were injected. These Granulomas, , foriegn body reactions , siliconoma usually don’t develop for twenty to thirty years. For the people using these products their problems are down the road a bit. Many of these scam scar treatment companies selling these silicone scar creams will probably long gone when the problems develop for these patients using their products now. Having been directly involved with Dr. Thomas Mustoe on gel sheeting vs elastomer silicone sheeting research he should know better than to indorse these silicone ointments as safe. They can be effective because they get the macrophages activated , but he knows they do form granulomas around the larger silicone gel and ointment molecules.