Volume 1, Issue 3, September 2015, Page: 42-45
Comparison Efficacy of Onion Extract plus Heparin with Flucinolone Acetonide on Midsternotomy Hypertrophic Scars Following Open Heart Surgery
Seyed Jalil Mirhosseini, Department of Cardiac Surgery, Afshar Hospital, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
Sadegh Ali-Hassan-Sayegh, Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
Alireza Vahidi Mehrjardi, Department of Pharmacology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
Maryam Hadibarhaghtalab, Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
Seyed Mohammad Yousof Mostafavi-Pour-Manshadi, Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran; Deparment of Medicine, Ali Ben Abitalib Medical College, Islamic Azad University, Yazd, Iran
Nafiseh Naderi, Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran; Deparment of Medicine, Ali Ben Abitalib Medical College, Islamic Azad University, Yazd, Iran
Mohammad Reza Lotfaliani, Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
Received: Jun. 8, 2015;       Accepted: Aug. 10, 2015;       Published: Aug. 11, 2015
DOI: 10.11648/j.ijcems.20150103.13      View  3913      Downloads  65
Abstract
Background. Post-midsternotomy hypertrophic scars can lead to remarkable morbidities such as pigmentation alteration, pain, tenderness, induration, itching, and erythema so that they may be cosmetically and emotionally unacceptable to the patient undergoing midsternotomy. Initially, wound healing is induced rapidly with re-epithelialization, whereas tissue remodeling occurs several months later to create a regular scar. This study was undertaken to evaluate the efficacy of onion extract plus heparin versus Fluocinolone acetonide on scar formation after midsternotomy in patients who are candidates for coronary bypass graft (CABG) surgery. Materials and Methods. One hundred patients undergoing off- pump coronary artery bypass graft (CABG) surgery were randomly assigned into two groups, group A, onion extract plus heparin (n=50), and group B, flucinolone acetonide (n=50). After performing midsternotomy for accessing to intra-chest cavity, the target vessel was exposed and snared above the anastomosis site with zero to four sutures and a soft plastic snugger was applied to prevent coronary injury. A skilled surgeon sutured incisions of the midsternotomy. The topical treatments (gel) were started one week post operation. Subjects were then asked to return to cardiovascular center three months after the surgery for evaluation of their wounds and condition of their scars. The postoperative parameters such as indurations, erythema, pigmentation alteration, itching, cosmetic appearance, raised area of the incision, tenderness, sternal wound infection, and duration of incision improvement were evaluated by method of Vancouver scar scale. Results. The average age of all the patients was 63.8±11, 63±11.5 was related to fluocinolon acetonide group (FA) and 64±10 related to onion extract plus heparin group (OEH). Postoperative rise in scar area was observed in 63 cases, 28 cases (56%) in OEH and 35 cases (70%) in FA (p=0.14). Postoperative erythema and itching had not significant differences in both groups, therefore, onion extract plus heparin could not diminish these complications after open heart surgery (p>0.05). Conclusion. Onion extract plus heparin significantly decreased pigmentation alternation, duration of incision improvement, and tenderness after midsternotomy.
Keywords
Onion Extract, Heparin, Hypertrophic Scars, Midsternotomy, Off-Pump CABG
To cite this article
Seyed Jalil Mirhosseini, Sadegh Ali-Hassan-Sayegh, Alireza Vahidi Mehrjardi, Maryam Hadibarhaghtalab, Seyed Mohammad Yousof Mostafavi-Pour-Manshadi, Nafiseh Naderi, Mohammad Reza Lotfaliani, Comparison Efficacy of Onion Extract plus Heparin with Flucinolone Acetonide on Midsternotomy Hypertrophic Scars Following Open Heart Surgery, International Journal of Clinical and Experimental Medical Sciences. Vol. 1, No. 3, 2015, pp. 42-45. doi: 10.11648/j.ijcems.20150103.13
Reference
[1]
Zurada JM, Kriegel D, Davis IC. Topical treatments for hypertrophic scars. J Am Acad Dermatol. 2006;55:1024-1031.
[2]
Farahnaz FN, Jamshid N, Koroush A. Comparison of therapeutic response of keloids and hypertrophic scars to cryotherapy plus intralesional steroid and bleomycin tattoo. Indian J Dermatol. 2005;50:129-132.
[3]
Namazi MR, Fallahzadeh MK, Schwartz RA. Strategies for prevention of scars: what can we learn from fetal skin? Int J Dermatol. 2011;50:85-93.
[4]
Campanati A, Savelli A, Sandroni L, et al. Effect of allium cepa-allantoin-pentaglycan gel on skin hypertrophic scars: clinical and video-capillaroscopic results of an open-label, controlled, nonrandomized clinical trial. Dermatol Surg. 2010;36:1439-1444.
[5]
Viera MH, Amini S, Konda S, Berman B. Do postsurgical interventions optimize ultimate scar cosmesis. G Ital Dermatol Venereol. 2009;144:243-257.
[6]
Koc E, Arca E, Surucu B, Kurumlu Z. An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic scars and keloids. Dermatol Surg. 2008; 34:1507-1514.
[7]
Draelos ZD. The ability of onion extract gel to improve the cosmetic appearance of postsurgical scars. J Cosmet Dermatol. 2008; 7:101-104.
[8]
Hosnuter M, Payasli C, Isikdemir A, Tekerekoglu B. The effects of onion extract on hypertrophic and keloid scars. J Wound Care. 2007; 16:251-254.
[9]
Ho WS, Ying SY, Chan PC, Chan HH. Use of onion extract, heparin, allantoin gel in prevention of scarring in Chinese patients having laser removal of tattoos: a prospective randomized controlled trial. Dermatol Surg. 2006; 32:891-896.
[10]
Beuth J, Hunzelmann N, Van Leendert R, Basten R, Noehle M, Schneider B. Safety and efficacy of local administration of contractubex to hypertrophic scars in comparison to corticosteroid treatment. Results of a multicenter, comparative epidemiological cohort study in Germany. In Vivo. 2006;20:277-283.
[11]
Chung VQ, Kelley L, Marra D, Jiang SB. Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study. Dermatol Surg. 2006;32:193-197.
[12]
Jenwitheesuk K, Surakunprapha P, Jenwitheesuk K, Kuptarnond C, Prathanee S, Intanoo W. Role of silicone derivative plus onion extract gel in presternal hypertrophic scar protection: a prospective randomized, double blinded, controlled trial. Int Wound J. 2012;9:397-402.
[13]
Shockman S, Paghdal KV, Cohen G. Medical and surgical management of keloids: a review. J Drugs Dermatol. 2010;9:1249-1257.
[14]
Aysan E, Bektas H, Ersoz F, Sari S, Huq G. Effects of contractubex on the prevention of postoperative peritoneal adhesion. J Surg Res. 2010;164:193-197.
[15]
Perez OA, Viera MH, Patel JK, et al. A comparative study evaluating the tolerability and efficacy of two topical therapies for the treatment of keloids and hypertrophic scars. J Drugs Dermatol. 2010;9:514-518.
Browse journals by subject