If you break your arm, you will probably get a cast to hold the bone in place while it heals. Now there is a similar device for your skin: a bandage that prevents injured skin from deforming as it heals, dramatically reducing scarring.
Geoffrey Gurtner at Stanford University in California and colleagues say their invention works by immobilising the wound and the surrounding area, shielding it from the stress of everyday activity.
“From the wound’s point of view, healing is sort of like trying to build a bridge while someone is driving trucks over it,” saysReinhold Dauskardt, who is also at Stanford. “Controlling the mechanical environment in which the wound is healing has a profound effect on scarring.”
The bandage is made from load-baring layers of transparent silicone polymer and Teflon sheets lined with pressure-sensitive adhesive. The material is cut to fit the shape of the wound and pressed onto the skin with an applicator that applies just the right amount of pressure to the bandage to ensure that it won’t move.
The bandage holds the skin taut at the edges of the wound, absorbing the everyday stresses that would normally tug and twist the healing wound.
To test the bandage, the researchers cut several chunks of flesh from six Duroc pigs, whose skin closely resembles our own. They then sutured the holes and applied the bandages to some wounds, while leaving others to heal with a standard dressing. Eight weeks later, scarring in the bandaged wounds was one-sixth or less of that in conventionally dressed wounds.
When Gurtner’s team analysed the pigs’ skin at a cellular level they found that the bandaged wounds had far fewer signs of fibrosis – the overactive growth of connective tissue that causes scarring.
Nine people undergoing abdominoplasty, more commonly known as a tummy tuck, volunteered to test the new bandage. Gurtner’s team applied the bandage to one half of each patient’s abdomen after surgery, treating the other half with a standard dressing. Eight and 12 months later, abdominal scarring was evaluated by three lay volunteers and three plastic surgeons. Both panels agreed that scarring in the bandaged half of the abdomen was less than in the traditionally treated half (Annals of Surgery, DOI: 10.1097/SLA.0b013e318220b159).
“It’s almost like recreating a fetal environment for the wound,” says Dauskardt. “A wound in a mammal fetus heals almost perfectly with no evidence of scarring, which might be because a fetus floats in a relatively stress-free environment.”
“This is an excellent study. The idea of a bandage that will shield stress is a novel idea,” says Thomas Mustoe, a plastic surgeon and expert in wound healing at Northwestern University in Chicago. “It absolutely merits further testing, and what they have may turn out to be very useful.”