Prevention of Hypertrophic Scars or Keloids (RCT)
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Purpose
Keloids and hypertrophic scars are not major illness. However, their effects can be from causing pain and itch which substantially interfere daily activity to as severe as causing deformity and other functional impairment. For standard surgical wounds, taking median sternotomy wounds from open heart surgery and lower abdominal wounds from gynecological wounds for example, the incidence of these problems can be from 10% to 60%. To prevent or treat these problems, physicians have used many modalities. One of the most convenient, most cost-effective and most non-invasive methods for patients is using dressings like silicone sheets, silicone gels or paper tapes, which is on the list of 1st line choices of an international recommendation. According to a literature review, most of the previous studies on similar topics are either of small sample size, on non-standard wounds or comparisons between wounds on different patient groups. The methodologies of previous studies are thus not vigorous enough. To get the highest level of evidence on selecting the best dressings for preventing and treating keloids and hypertrophic scars, we will recruit about 75 patients and apply two selected dressings on each halves of their standard surgical wounds to compare their differences. The investigators hope the result of this study can help us find the best modality to use and can contribute to the welfare of our future patients.
| Condition | Intervention |
|---|---|
|
Hypertrophic Scars |
Other: silicone gel Other: silicone sheet Other: paper tape |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Factorial Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Comparison of the Effectiveness in Prevention of Hypertrophic Scars or Keloids Between Silicone Sheet, Silicone Gel and Paper Steri-strip-A Randomised Controlled Trial. |
- Scar appearance measured with Vancouver Scar Scores. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- pain and itchiness measured with Visual Analog Scales. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 75 |
| Study Start Date: | March 2009 |
| Estimated Study Completion Date: | December 2012 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Gel vs. Sheet
One group will act to compare the effectiveness between silicone gel and silicone sheet.
|
Other: silicone gel
silicone gel
Other: silicone sheet
silicone sheet
|
|
Active Comparator: sheet vs. paper tape
The second group between silicone sheet and paper tape.
|
Other: silicone sheet
silicone sheet
Other: paper tape
paper tape
|
|
Active Comparator: gel vs. paper tape
One group will act to compare the effectiveness between silicone gel and paper tape.
|
Other: silicone gel
silicone gel
Other: paper tape
paper tape
|
Detailed Description:
Patients who undergo gynecological surgery with transverse lower abdominal wounds and who undergo cardiovascular surgery with median sternotomy wounds in our hospital will be assessed. Those who have or will have diabetes, chemotherapy, radiotherapy and known history of allergy to silicone will be excluded. Altogether, about 75 patients will be recruited. Each patient's wound will be divided into two halves. One test dressing will be applied to a half, which is determined by random, and a different test dressing to the other half. The total 75 patients will thus be divided into 3 groups of 25 patients. One group will act to compare the effectiveness between silicone gel and silicone sheet, the second group between silicone sheet and paper tape, and the third group between silicone gel and paper tape. The dressings will be applied one week after surgery and at least 12 hours per day until 3 months after surgery. All patients will be followed up at 4 weeks, 8 weeks, 12 weeks, 6 months and 12 months. Three domains of outcomes will be measured. One is the appearance of the scars which will be rated with Vancouver scale, which has been proved to be a reliable scale.34 35 When rating with the Vancouver scale, standardised photographs of the scars will be taken in a standardised photo studio using a single high-resolution digital camera in a standardised light condition and at a fixed distance because any difference in photographic conditions will make difference in the Vancouver scores. The other two domains are pain and itching of the scars, which will be evaluated with Visual Analog Ratings (VAR). Pain and itching are very subjective, so the rating method should be very easy to understand and applicable for our patients and that is why we chose VAR as a tool.
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients who undergo gynecological surgery with transverse lower abdominal wounds.
- Patients who undergo cardiovascular surgery with median sternotomy wounds in our hospital will be assessed.
Exclusion Criteria:
Those who have or will have:
- diabetes
- chemotherapy
- radiotherapy
- known history of allergy to silicone will be excluded.
Contacts and Locations| Taiwan | |
| Kaohsiung Veterans General Hospital: R.O.C. | |
| Kaohsiung, Taiwan, 813 | |
| Principal Investigator: | Kuei-Chang Hsu, surgeon | Department of plastic surgery in Kaohsiung Veterans General Hospital in Taiwan |
More Information
Publications:
| Responsible Party: | Kuei-Chang Hsu, Consultant Surgeon, Kaohsiung Veterans General Hospital. |
| ClinicalTrials.gov Identifier: | NCT00849004 History of Changes |
| Other Study ID Numbers: | 97CT1018, 97CT1018 |
| Study First Received: | February 20, 2009 |
| Last Updated: | October 19, 2012 |
| Health Authority: | Taiwan: Institutional Review Board |
Keywords provided by Kaohsiung Veterans General Hospital.:
|
keloid silicone sheet silicone gel paper tape steri-strip |
Additional relevant MeSH terms:
|
Hypertrophy Keloid Cicatrix, Hypertrophic Cicatrix Pathological Conditions, Anatomical |
Collagen Diseases Connective Tissue Diseases Fibrosis Pathologic Processes |
ClinicalTrials.gov processed this record on May 16, 2013