Comparison of the Efficacy Between the Combination of Herbal Extracts and Silicone Derivative VS the Combination of Herbal Extracts, Silicone Derivative and Sunscreen in Reducing Scar Development at Donor Site of the Split Thickness Skin Graft

Background: To compare the efficacy between the combination of herbal extracts and silicone derivative VS the combination of herbal extracts, silicone derivative and sunscreen in reducing scar development at the split-thickness skin graft donor site and also the different between the two treatment groups and placebo. Methods: A prospective randomized double-blind control study to compare efficacy between the combination of herbal extracts and silicone derivative (Group I) VS the combination of herbal extracts, silicone derivative and sunscreen (Group II) VS placebo (Group III) in reducing scar development at the split-thickness skin graft donor site within 1 month after complete epithelialization. Scar assessments using the Vancouver Scar Scale (VSS) and Cutometer® (The Multiprobe Adapter System Cutometer Dual MPA580) were taken 4, 8, 16 and 24 weeks postoperatively. Results: Of the 12 patients, 8 were enrolled, total 18 split-thickness skin graft donor sites were evaluated in this study. There was statistically significant lower in itching parameter of VSS between treatment groups compared to the placebo group after 8 weeks of treatment; Group I VS Group III (p = 0.003, 0.002, 0.002 at 8, 16, 24 weeks, respectively), Group II VS Group III (p = 0.003, 0.002, 0.002 at 8, 16, 24 weeks, respectively). After 24 weeks of treatment, there was statistically significant lower erythema index in Group II when compare to Group III (359.09 VS 378.40, p = 0.004). There was statistically significant lower melanin index in both treatment groups when comparerd to placebo group; Group I VS Group III (317.80 VS 341.600, p = 0.013)) and Group II VS Group III (316.19 VS 341.60, p = 0.028). There was no statistically significant different in pliability index between groups. Conclusion: The results from this study confirmed that the combination of herbal extracts and silicone derivative with or without sunscreen could reduce scar itching and these combinations might improve scar pigmentation and tend to reduce scar erythema.