Fluid silicone gels in the prevention and treatment of hypertrophic scars: a systematic review and meta-analysis of randomised controlled trials

Hypertrophic scars are a benign yet potentially debilitating cutaneous manifestation, characterised by elevated, pigmented scarring confined within the wound boundaries. They can affect the patients both physically, through pruritus, pain, stiffness and contractures, and also psychologically through stigmatization, anxiety, depression, diminished self-esteem and daily activity disruption, reducing the quality of life. There are currently various treatments used, and although silicone gel fluid is widely recognised as a leading non-invasive treatment, there is inconsistent evidence of superiority. A systematic review of the literature was conducted on the Ovid Medline (R), Embase, CiNAHL and the Cochrane Library databases in accordance with PRISMA guidelines. Ultimately 35 papers were included as part of the systematic review and 20 were analysed in our meta-analysis. Only randomised controlled trials were included. Silicone gel fluid was compared against placebo, no treatment, silicone gel sheets and other conventionally used treatments. Through this review we provide the efficacy of silicone gel fluids against different controls, present the reported adverse effects, identify gaps in current knowledge and provide a robust foundation for future studies. Since silicone gels are commonly used in clinical practice dermatologists should be updated on their actual effectiveness, comparability and current knowledge, to provide the patients with the most informed and appropriately tailored treatment plan.