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1.
Plast Reconstr Surg ; 134(3): 536-546, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24804638

ABSTRACT

BACKGROUND: Scarring represents a significant biomedical burden in clinical medicine. Mechanomodulation has been linked to scarring through inflammation, but until now a systematic approach to attenuate mechanical force and reduce scarring has not been possible. METHODS: The authors conducted a 12-month, prospective, open-label, randomized, multicenter clinical trial to evaluate abdominoplasty scar appearance following postoperative treatment with the embrace Advanced Scar Therapy device to reduce mechanical forces on healing surgical incisions. Incisions from 65 healthy adult subjects were randomized to receive embrace treatment on one half of an abdominoplasty incision and control treatment (surgeon's optimal care methods) on the other half. The primary endpoint for this study was the difference between assessments of scar appearance for the treated and control sides using the visual analogue scale scar score. RESULTS: Final 12-month study photographs were obtained from 36 subjects who completed at least 5 weeks of dressing application. The mean visual analogue scale score for embrace-treated scars (2.90) was significantly improved compared with control-treated scars (3.29) at 12 months (difference, 0.39; 95 percent confidence interval, 0.14 to 0.66; p = 0.027). Both subjects and investigators found that embrace-treated scars demonstrated significant improvements in overall appearance at 12 months using the Patient and Observer Scar Assessment Scale evaluation (p = 0.02 and p < 0.001, respectively). No serious adverse events were reported. CONCLUSIONS: These results demonstrate that the embrace device significantly reduces scarring following abdominoplasty surgery. To the authors' knowledge, this represents the first level I evidence for postoperative scar reduction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Subject(s)
Abdominoplasty , Bandages , Cicatrix/prevention & control , Postoperative Care/instrumentation , Postoperative Complications/prevention & control , Adolescent , Adult , Aged , Cicatrix/etiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Photography , Postoperative Care/methods , Prospective Studies , Treatment Outcome , Visual Analog Scale , Wound Healing , Young Adult
2.
Plast Reconstr Surg ; 133(2): 398-405, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24105084

ABSTRACT

BACKGROUND: Mechanically offloading or shielding an incision significantly reduces scarring in both animal and first-in-human studies. Whether or not this strategy would be effective following scar revision surgery was previously unknown. In this article, the authors report that the embrace device, which uses principles of mechanomodulation, significantly improves aesthetic outcomes following scar revision surgery. METHODS: A prospective, open-label, randomized, single-center study was conducted to evaluate the appearance of scars following revision and embrace treatment. Revision surgery was performed on 12 patients, each acting as his or her own control, and outcomes were assessed at 6 months. A visual analogue scale was used to evaluate each scar, rated by four independent surgeons who were not involved in the study. RESULTS: Evaluation of 6-month scar images by four independent surgeons using the visual analogue scale demonstrated a highly significant improvement in scar appearance following embrace treatment (p < 0.005). CONCLUSION: The embrace device represents a powerful new technology for significantly improving scar appearance following revision surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Subject(s)
Bandages , Cicatrix/prevention & control , Silicone Elastomers , Adolescent , Adult , Aged , Cicatrix/etiology , Cicatrix/surgery , Equipment Design , Female , Humans , Male , Middle Aged , Prospective Studies , Reoperation/adverse effects , Young Adult
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