- 期刊
矽膠貼片對於蟹足腫及肥厚性疤痕治療之實證醫學回顧
Silicon Gel Sheeting for Treatment of Hypertrophic and Keloid Scars: An Evidence-Based Medicine Review
摘要
背景：臨床上常使用矽膠貼片(silicon gel sheeting)來治療蟹足腫及肥厚性疤痕，其實際效果究竟如何值得探討。 目的：探討矽膠貼治療蟹足腫及肥厚性疤痕的效果。 文獻選擇及資料來源：使用Medline, EMBASE尋找關於矽膠貼片與蟹足腫及肥厚性疤痕的研究。 文獻分析：引用了一篇關於矽膠貼片與治療蟹足腫及肥厚性疤痕的系統性回顧研究，此文獻涵蓋了近年來15個隨機對照臨床試驗。統合分析發現使用矽膠貼片治療，可有效的降低蟹足腫及肥厚性疤痕的厚度，但對疤痕長度、寬度的改善、縮小疤痕至少50%、疤痕顏色淡化，疤痕彈性的改變，疤痕疼痛及癢的改善，則與對照組沒有顯著的差異。若拿矽膠貼片與病灶內注射類因醇相比較，則發現類因醇比矽膠貼片能夠縮小疤痕至少50%以上及改善病灶發紅的情形，但相對地引起副作用的比率較高。 結論：目前支持矽膠貼片可有效地治療蟹足腫及肥厚性疤痕的實證醫學證據並不強，在眾多的結果指標中，只有減少疤痕的厚度有顯著的意義，顯示還需要更多品質更好的臨床試驗來證實其療效。
關鍵字
無資料並列摘要
Context: Silicon gel sheeting has been used for more than twenty years to prevent and treat hypertrophic scars and keloid. However, evidence is needed to support the use of silicon gel sheeting for hypertrophic scars and keloid. Objective: To determine the effectiveness of silicon gel sheeting for treatment of people with established keloid or hypertrophic scars. Data Source and Study Selection: Comprehensive literature search concerning silicon gel sheeting treatment effect of keloid or hypertrophic scars was performed using Medline and EMBASE (1995 to May 2008). Eleven articles were identified, among which one Cochrane systematic review was examined in this study. Main Results: This Cochrane systematic review included 15 randomized or quasi-randomized controlled trials. There was a statistical difference in scar thickness between silicon gel sheeting treatment and no treatment groups. However, no differences in scar length, width, color amelioration, reduction of scar size by 50%, scar elasticity, itch and pain relief were detected among silicon gel sheeting treatment and control groups. Besides, silicon gel sheeting was less effective in scar size reduction and erythema amelioration than intralesional steroid injection. Conclusion: There was limited evidence to support silicon gel sheeting for treatment of hypertrophic scars or keloid due to lack of high quality studies. Further high quality studies are needed to confirm the clinical efficacy of silicon gel sheeting for treatment of hypertrophic scars or keloid.