Khoo Teng, Lye
F8 a prospective, randomized, double-blinded trial to study the
efficacy of topical tocotrienol in the prevention of hypertrophic
scars.
Other.
Pusat Pengajian Sains Perubatan.
(Submitted)
Abstract
Despite widespread beliefs regarding the use of topical tocotrienol in the prevention
of hypertrophic scars, there is very little evidence from well-controlled and randomized clinical trials
to justify its benefits for surgical scars.
Objective: The present study was conducted to evaluate the efficacy of topical tocotrienol in
preventing the development of hypertrophic scars.
Methods: A prospective, randomized, double-blinded study was performed in which the patients
were randomized into either treatment group with 5% topical tocotrienol or a placebo group. The
patients were required to apply the preparation to their scars twice a day for six weeks starting at
two weeks after surgery. An evaluation of the scars was performed at weeks 0, 2, 6 and 16
following the onset of topical application using three methods: a clinical assessment using the
Patient and Observer Scar Assessment Scale (POSAS), a photographic scar assessment by two
independent assessors using a visual analogue scale, and laser Doppler imaging (LDI).
Results: There was no statistically significant difference in scar parameters between the
tocotrienol group (n=43) and the placebo group (n=40) in the POSAS, photographic scar
assessment or mean flux of LDI (p>0.05). The mean LDI flux showed decreasing trend over time,
which was positively correlated with the vascularity score (correlation coefficient=0.322) of
observer scar assessment scale on week 0 (p=0.018) and total score of the patient scar
assessment scale on week 6 (correlation coefficient=0.354, p=0.009). No significant adverse
effects were observed.
Conclusions: Twice daily application of 5% topical tocotrienol had no significant effect on the
appearance and perfusion of scars over four months post-surgery. LDI has a promising role as a
scar assessment tool.
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