A comparative clinical study of the treatment of hypertrophic scars with intralesional steroid and silicone gel sheeting in different types of incision lines in caesarean sections

Abstract

Caesarean section is one of the most common interventions in obstetrics and gynecology today. Complications of scar healing and also the aesthetics of the scar is usually very important for patients. 96 patients were selected to participate in this study after giving birth by caesarean section. Each group included 24 patients, who underwent a Pfannenstiel section or a transverse laparotomy incision. The patients were treated with either intralesional steroid or silicone gel sheeting. The aim of this study was to compare and determine the roles of these two commonly used treatment options of hypertrophic scars and to compare the therapeutic options in different incisions in case of caesarean sections. Both methods were significantly efficient, however intralesional steroid therapy had a more rapid and long-lasting effect than silicone gel sheeting in both types of incisions of caesarean sections. These results confirmed the role of these two treatment modalities in the protocols. Our data suggest that silicone gel sheeting could be the first line therapy in both types of incisions of caesarean sections, while intralesional steroid is the second line treatment for primary linear hypertrophy of scars. Also, in recurrent linear hypertrophic scars, intralesional steroid therapy is recommended in first line in both types of incisions, because silicone gel sheeting was largely ineffective. Regarding the type of caesarean sections, in lower transverse laparotomy both types of treatment proved to be more effective, thus this could be an argument for the surgeon to choose this type of incision detrimental to the lower median laparotomy. Prospective randomized clinical trials should be needed to clarify their role further in the treatment protocols.