Failure of topical steroids and vitamin E to reduce postoperative scar formation following reconstructive surgery

• Published in: Journal of burn care & rehabilitation Vol. 7; no. 4; p. 309
• Main Authors: Jenkins, M, Alexander, J W, MacMillan, B G, Waymack, J P, Kopcha, R
• Format: Journal Article
• Language: English
• Published: United States 01.07.1986
• Subjects: Administration, Topical; Burns - complications; Cicatrix - prevention & control; Clinical Trials as Topic; Contracture - surgery; Humans; Ointments; Postoperative Complications - prevention & control; Prospective Studies; Random Allocation; Steroids - administration & dosage; Surgery, Plastic; Vitamin E - administration & dosage
• ISSN: 0273-8481
• DOI: 10.1097/00004630-198607000-00002

One hundred fifty-nine operative procedures for postburn contractures of interdigital webs (96), the axilla (46), or the neck (17) were prospectively randomized to be treated postoperatively for four months with a topical steroid (Aristocort A), topical vitamin E, or the base cream carrier for these drugs. The nature of the medication was blinded both to the patient and to the evaluator. Patients were followed for one year. Observations were made for range of motion, scar thickness, change in graft size, and ultimate cosmetic appearance. No beneficial effect of either vitamin E or topical steroid could be demonstrated. However, adverse reactions occurred in 16.4% of patients receiving active drug, compared to 5.9% treated only with base cream. Interestingly, the grafts initially contracted and subsequently grew to be a size larger (about 20%) than the original graft by one year. It is concluded that neither topical steroid nor topical vitamin E is effective in reducing scar formation after grafting procedures for reconstruction for postburn contractures.