Answer:
Silicone sheeting has been used to treat and prevent hypertrophic scars around the body, including those in burn patients. The mechanism for its beneficial effects is not well understood. It is not thought to be related to any change which the silicone sheeting may have in pressure, temperature, or the partial pressure of oxygen around the scar. One theory is that the silicone gel reduces water vapor loss and restores homeostasis to the scar, thus reducing capillary hyperemia, collagen deposition, and hypertrophic scar formation. A second theory postulates that a chemical interaction between the silicone and the skin inhibits fibroblast growth. In Cruz-Korchin’s 1996 study, she studied the effect of silicone sheeting on breast scars after reduction mammoplasty. She had twenty women who had bilateral reductions wear the sheet on one side only for 12 hours a day for 2 months. The other breast was left uncovered acting as a control. The scars were evaluated at two months and six months after surgery. She found that after 2 months, 60% of the nontreated scars were hypertrophic compared to 25% on the treated side. A similar ratio (55% vs. 25%) was seen at 6 months. Although the study was not blinded and required the subjective evaluation of scar appearance, the difference seen between a treated and untreated breast in the same patient lends some weight to the concept that silicone sheeting can make a difference in reducing scars within the short term.