摘要：Objective: Many topicals claim an efficacious role in skin scar management with limited evidence. Our aim is to present a clear format for functional testing of a skin scarring ointment, using noninvasive and invasive measurements, categorizing findings under the physiological, structural, and mechanical parameters of a scar., Approach: A double-blinded, randomized volunteer research study of 45 subjects receiving an ointment composing of natural ingredients against a widely used antiscarring topical used as a positive control with temporal sequential punch biopsies (up to 16 weeks) was evaluated using noninvasive quantitative devices and validated by gene and protein studies., Results: Outcome measures included physiological, mechanical, and structural features of scars. Significant non-invasive findings included an increase in skin hydration (p?<?0.05) at week (W) 4, 8, and 12, and elasticity (W16; p?=?0.009). These findings were validated by immunohistochemistry (IHC) and quantitative real-time PCR (qRT-PCR). Hyaluronic acid IHC (W4 p?=?0.014, W12 p?=?0.034, and W16 p?=?0.042), qRT-PCR (W16 p?=?0.049); Collagen I (W16 p?=?0.034, and 0.049) IHC and qRT-PCR, respectively. Collagen III qRT-PCR (W12 p?=?0.035, and W16 p?=?0.32); elastin IHC (W12 p?=?0.044); and fibronectin IHC (W4 p?=?0.009, W12 p?=?0.038, and W16 p = 0.026)., Innovation: Utilizing this model allows for quantitative, objective evaluation of any topical, where previously there has been a paucity of relevant methods to evaluate their effect., Conclusions: The positive effect of a topical formulation with an unknown mechanism of action on early cutaneous scar maturation over progressive sequential time points is now evidenced using noninvasive and invasive techniques with the findings categorized on the basis of scarring parameters.

摘要：CONTEXT: Moist exposed burn ointment (MEBO), from China, has been said to revolutionize burn management. OBJECTIVE: Our study was conducted to compare MEBO with conventional management (C) with respect to the rate of wound healing, antibacterial and analgesic effect, and hospital costs. DESIGN: This is a prospective, randomized, controlled clinical trial conducted between 1 March 1997 and 24 October 1998. SETTING: The trial was conducted in a specialized burn facility located in a tertiary referral hospital in a developed and industrialized island-state in Southeast Asia. PATIENTS: We randomly assigned 115 consecutive patients between the ages of 12 and 80 who had partial-thickness thermal burns covering less than 40% of body surface area (BSA) to receive either MEBO or C. Fifty-seven patients were assigned to MEBO and 58 patients to C. The latter group received twice-daily dressing changes; MEBO patients received MEBO every 4 hours. MAIN OUTCOME MEASURES: Patients were hospitalized until 75% BSA had healed. BSA was determined by visual inspection and charted on Lund and Browder charts regularly. Wound healing rate, bacterial infection rate, pain score, and hospitalization costs were recorded. RESULTS: The median time to 75% healing was 17.0 and 20.0 days with MEBO and C, respectively (HR = 0.67, 95% CI = 0.41-1.11, P =.11), suggesting similar efficacy between the 2 modalities. Bacterial infection rates were similar between the 2 groups (HR = 1.10, 95% CI = 0.59-2.03, P =.76). MEBO imparted a greater analgesic effect in the first 5 days of therapy and reduced hospital costs by 8%. CONCLUSIONS: MEBO is as effective as conventional management but is not the panacea for all burn wounds. The use of MEBO eases the management of face and neck burns and facilitates early institution of occupational therapy in hand burns. It confers better pain relief such that fewer opiates are used during the first 5 days after burn injury.

摘要：Aim. This study aimed to compare the effect of MEBO versus 0.2% hyaluronic acid gel (Gengigel?) applied to the palatal donor site on postoperative pain reduction and wound healing after free gingival graft harvesting. Methodology. Thirty-nine patients with different mucogingival defects were included in this study for harvesting a free gingival graft (FGG) for soft tissue augmentation. Patients were randomly assigned into three equal groups: group I (MEBO), group II (0.2% HA Gengigel?), and group III (control). Postoperative pain was recorded by using the Visual Analogue Scale (VAS). Analgesic consumption was recorded for 7 days postoperatively. Wound size was measured at baseline and on days 3, 7, 14, and 21. Postoperative healing of the palatal wound was assessed by the VAS score for color match on days 3, 7, 14, 21, and 42. Results. Results of this study showed significant postoperative pain reduction for the three groups; MEBO showed statistically significant less VAS score compared to the other two groups, while HA showed statistically significant less VAS score compared to the control group. Both MEBO and HA showed statistically significant less total analgesic consumption. No statistically significant difference was observed between groups for wound size. MEBO showed statistically significant higher VAS for color match. Conclusions. Both treatment modalities could reduce postoperative pain following harvesting of FGG and improve the palatal wound healing. However, MEBO showed better outcomes in terms of postoperative pain and color match.

摘要：Wound healing after dermal injury is an imperfect process, inevitably leading to scar formation as the skin re-establishes its integrity. The resulting scars have different characteristics to normal skin, ranging from fine-line asymptomatic scars to problematic scarring including hypertrophic and keloid scars. Scars appear as a different colour to the surrounding skin and can be flat, stretched, depressed or raised, manifesting a range of symptoms including inflammation, erythema, dryness and pruritus, which can result in significant psychosocial impact on patients and their quality of life. In this paper, a comprehensive literature review coupled with an analysis of levels of evidence (LOE) for each published treatment type was conducted. Topical treatments identified include imiquimod, mitomycin C and plant extracts such as onion extract, green tea, Aloe vera, vitamin E and D, applied to healing wounds, mature scar tissue or fibrotic scars following revision surgery, or in combination with other more established treatments such as steroid injections and silicone. In total, 39 articles were included, involving 1703 patients. There was limited clinical evidence to support their efficacy; the majority of articles (n?=?23) were ranked as category 4 LOE, being of limited quality with individual flaws, including low patient numbers, poor randomisation, blinding, and short follow-up periods. As trials were performed in different settings, they were difficult to compare. In conclusion, there is an unmet clinical need for effective solutions to skin scarring, more robust long-term randomised trials and a consensus on a standardised treatment regime to address all aspects of scarring.