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The Use of Pressure and Silicone in Hypertrophic Scar Management in Burns Patients: A Pilot Randomized Controlled Trial

Harte, Daniel BSc*; Gordon, Jude BSc; Shaw, Maxine DPhys; Stinson, May PhD; Porter-Armstrong, Alison DPhil§

doi: 10.1097/BCR.0b013e3181ac01a3
Original Articles

This pilot study investigates whether pressure and silicone therapy used simultaneously are more effective in treating multiple characteristics of hypertrophic scars than pressure alone. A pilot randomized controlled trial was conducted. Twenty-two participants with hypertrophic burn scars were randomized to receive Jobskin pressure garments and Mepiform silicone sheeting or Jobskin pressure garments alone. The Vancouver Scar Scale (VSS) was used to measure multiple scar characteristics at baseline, week 12, and week 24. No statistically significant difference was found in the rate of change of the VSS scores between the pressure therapy (PT) group and the pressure therapy and silicone group at week 12 or week 24; however, the mean scores of both groups reduced over 24 weeks. There were no statistically significant changes in the VSS subscores (scar height, vascularity, pliability, and pigmentation) from baseline to week 12 or week 24. A statistically significant relationship was observed between the VSS score and TBSA burned (<30%) in the PT group at baseline (P < .05), over 12 weeks (P < .05), and over 24 weeks (P < .05). Given the limitations of this study, especially the small sample size, further research is necessary before any firm conclusions can be drawn on this therapy approach. However, this pilot study has discussed the recurring issues in the research regarding these controversial treatments and has yielded potential for further investigation in a fully powered randomized controlled trial.

From the *Royal Hospitals Trust, Belfast, Northern Ireland; †Belfast Health and Social Care Trust, Royal Victoria Hospital, Northern Ireland; ‡School of Health Sciences, University of Ulster, Northern Ireland; and §Health and Rehabilitation Sciences Research Institute, University of Ulster, Northern Ireland.

Daniel Harte is currently at Southern Health and Social Care Trust, Northern Ireland.

This study was supported by the Research and Development Office for the Health and Personal Social Services in Northern Ireland through provision of the R&D Bursary Scheme.

Address correspondence to Dr. Alison Porter-Armstrong, Health and Rehabilitation Sciences Research Institute, University of Ulster, Jordanstown, Shore Road, Newtownabbey, Co. Antrim, Northern Ireland.

© 2009 The American Burn Association