VITAMIN E ADDED SILICONE GEL SHEETS FOR TREATMENT OF HYPERTROPHIC SCARS AND KELOIDS

Background. Trauma of various origins can induce a connective tissue disorder that leads to keloids. This condition has yet not been clearly distinguished from scars and hypertrophic scars. Only electronmicroscopic and biochemical data can help to do this. Among some more or less therapeutic approaches, the use of silicon (polydimethylsiloxane) plates, wrapped on the keloid surface, has been reported effective by some authors. These authors also demonstrated that it is not the mechanical pressure that is the mechanism of action, but a direct action on fibroblasts and a hyperhydration of subcutaneous tissue. The authors of this study conceived that the silicon plate may be able to improve the transdermal penetration of a compound such as vitamin E. This vitamin is capable of preserving some important morphologic and functional features of biological membranes by means of its phytilside chain of the molecule acting as a stabilizer of lysosomal membranes. Materials and Methods. Eighty patients of both sexes, aged between 18 and 63 years, who had hypertrophic scars and keloids, were admitted to the trial. The patients were randomized to two groups in a simple-blinded study. Group A: Forty patients whose scars have been covered with silicon plates with added vitamin E. Group B: Forty patients treated with simple silicone gel sheets. No pressure bandages were used, only tape fixing the sheet for 10 hours overnight. The trial lasted for 2 months. The results were recorded at 4 and 8 weeks, evaluating the improvement according to a Scott-Husskinson scale. For objective assessment photos were taken. The results were analyzed by the chi-square test. Results. At the end of the first month, group A had improved by more than 50% in 85% of cases, whereas the improvement in group B was 55% (P < 0.01). At the end of the second month, 95% of patients in group A had improved by 50%, whereas 75% had improved by 50% in group B (P < 0.05). Conclusions. Vitamin E added to the silicon plate scored better than the simple silicon plate at the end of both periods. We have reported the successful combined action of vitamin E and silicone gel sheets in scar treatment, especially in the short-term prophylaxis of hypertrophic scars or keloids.     

Electromagnetic Interference from a Muscle Stimulation Device Causing Discharge of an Implantable Cardioverter Defibrillator: Epicardial Bipolar and Endocardial Bipolar Sensing Circuits Are Compared

This case report is about two patients with two different types of ICDs who underwent electrical muscle stimulation (EMS) therapy. In one patient with an ICD that has epicardial screw-in bipolar sensing leads, electromagnetic interference (EMI) from the EMS device caused the delivery of an inappropriate ICD discharge. In a second patient with an ICD with endocardial true bipolar sensing, there was no evidence of EMI during the EMS therapy despite all of our attempts to reproduce it. The sensing circuits in the two different ICDs are compared.