Lack of evidence against efficacy of Silicone gel sheets for keloids

A recent study by Fan Tian and team found that there is currently some lack of evidence to prove the effectiveness of silicone gel sheeting versus other treatments as non-silicone gel sheeting, or intralesional injections of triamcinolone acetonide in the management of keloid scars. The findings were published in Cochrane Database of Systematic Reviews.

One of the most typical types of pathological scarring is keloid scarring. When keloid scars don't heal properly, they can cause discomfort, itchiness, contractures, and cosmetic deformities, which can have an impact on both a person's physical and mental health. One of the most popular treatments for keloid scars is silicone gel sheeting (SGS), which is a silicone membrane-backed product created from medical-grade silicone. There is, however, no current systematic evaluation evaluating the efficacy of SGS for keloid scars. To help clinicians, healthcare administrators, and persons with keloid scarring, a thorough and lucid assessment of the most recent research is necessary. 

Standard Cochrane search techniques were employed by the researchers. December 2021 was the most recent search date. SGS' efficacy was evaluated in randomised controlled trials (RCTs) that enrolled participants with any type of keloid scar. Study selection, risk of bias assessment, data extraction, and GRADE assessment of the certainty of the evidence were all carried out independently by two review authors. Initial differences were settled through conversation or, if necessary, by consulting a third review author.

The key highlights of this study were:

1) The criteria for two studies were accepted. 

2) There were 16 and 20 study participants, respectively. 

3) Clinically, the trials varied in terms of scarring aetiology, scarring sites, and scar ages. 

4) The follow-up period lasted for three and a half years. 

5) Three comparisons were made between SGS and no treatment, SGS and non-silicone gel sheeting, and SGS and intralesional injections of triamcinolone acetonide in the included studies. 

6) A split-body design was used in one trial, and an uncertain design was used in the other.

7) The included studies provided scant information on the key review outcome of scar severity as determined by medical experts, and there was no information provided on scar severity as determined by patients or adverse events. 

8) Some data on pain were supplied for secondary outcomes, but cost-effectiveness and health-related quality of life were not. 

9) Because of the inadequate outcome reporting in both trials, numerous categories in the risk of bias were rated as uncertain. 

10) All of the evidence was given a very low level of assurance, mostly because of the possibility of bias, indirectness, and imprecision.

Reference: 

Tian, F., Jiang, Q., Chen, J., & Liu, Z. (2023). Silicone gel sheeting for treating keloid scars. In Cochrane Database of Systematic Reviews (Vol. 2023, Issue 1). Wiley. https://doi.org/10.1002/14651858.cd013878.pub2