皮膚科王修含醫師: 王修含醫師演講紀錄：治療疤痕、蟹足腫的矽膠產品 (衛福部記者會)

王修含醫師演講紀錄

主題：治療疤痕、蟹足腫的矽膠產品

主辦單位：衛生福利部 (記者會)

時間：2024年10月16日 10:00-11:00

地點：衛生福利部大樓 (台北市南港區忠孝東路6段488號1樓)

疤痕處理矽膠產品介紹

疤痕處理矽膠產品屬於第一等級醫療器材，風險等級低，非侵入性。這類產品的主要功能是減少疤痕，預防蟹足腫，常用於手術、燒傷及外傷的疤痕處理。

市售產品形式

矽膠片：持續保濕，幫助疤痕癒合。
矽膠凝膠：質地輕薄，適合日常使用，乾燥後可直接穿衣。

產品原理

疤痕處理矽膠產品的作用主要是保濕，這有助於減少經皮水分散失（TEWL），從而減少角質細胞和纖維母細胞的刺激，抑制過度膠原生成，防止疤痕增生。

矽膠作用機制

保濕作用：保持疤痕區域的水分，有助於修復角質層屏障。
減少刺激：降低角質細胞及纖維母細胞過度活化，防止疤痕增厚。
成分差異：某些產品添加維他命E或礦物油等成分，但是否可進一步改善效果，需更多研究結果支持。

矽膠凝膠與矽膠貼片的比較

特性	矽膠貼片	矽膠凝膠
使用方式	每日使用8-12小時，持續數月	每日塗抹2次，薄薄一層
優點	重複使用，持久效果	方便攜帶，日常使用便捷
缺點	不適合某些活動需求	需等待乾燥後才可穿衣

使用注意事項

矽膠貼片：使用前應清潔疤痕及周圍皮膚，必要時修剪多餘毛髮。貼片應每日持續使用，不可用於未癒合傷口。
矽膠凝膠：使用前應清潔疤痕部位，每日薄塗2次，等待乾燥後再穿衣，避免過敏反應。
使用禁忌：不可使用於未癒合傷口或感染部位。

臨床經驗分享

我們的臨床經驗表明，矽膠產品在處理嚴重疤痕時，效果顯著。尤其是針對肥厚性疤痕及蟹足腫，矽膠產品可作為輔助療法，並應結合其他治療手段，如冷凍療法、類固醇注射、染料雷射或肉毒桿菌素注射等。

案例展示

治療前：疤痕明顯，患者皮膚組織增厚。
治療中：矽膠產品與其他治療方式結合，持續觀察。
治療後：疤痕減少，皮膚回復平滑，效果顯著。

結論

矽膠產品是具科學依據的非侵入性疤痕治療方式，早期介入並持續使用是治療關鍵。針對不同疤痕狀況，正確選擇適合的產品並結合其他療法，將有助於達到最佳治療效果。

Introduction to Silicone Scar Treatment Products

Silicone scar treatment products are classified as low-risk, non-invasive medical devices. They are widely used to reduce scars and prevent keloids, suitable for treating scars from surgeries, burns, and trauma.

Available Product Forms

Silicone Sheets: Maintain moisture, aiding in scar healing.
Silicone Gels: Lightweight and convenient for daily use, allowing users to wear clothing over the treated area once dry.

Product Mechanism

The main mechanism of silicone scar treatment products is moisture retention, which helps to reduce transepidermal water loss (TEWL). This, in turn, decreases the over-activation of keratinocytes and fibroblasts, preventing excessive collagen production and scar formation.

Silicone's Mode of Action

Moisturizing Effect: Retains moisture in the scar area, helping restore the stratum corneum barrier.
Reducing Stimulation: Lowers irritation to keratinocytes and fibroblasts, minimizing scar thickening.
Differences in Composition: Some products contain additional ingredients like Vitamin E or mineral oil, which may enhance the overall effect.

Comparison Between Silicone Gel and Silicone Sheets

Characteristic	Silicone Sheets	Silicone Gels
Application	Worn 8-12 hours daily for months	Applied twice daily, a thin layer
Advantages	Reusable, long-lasting effect	Portable, convenient for daily use
Disadvantages	May not suit active lifestyles	Requires drying before dressing

Usage Instructions and Precautions

Silicone Sheets: Clean the scar and surrounding skin before use. Trim excess hair if needed. Apply the sheet firmly over the scar, and follow the manufacturer’s recommendations, typically worn 8-12 hours daily for 3-6 months. Not to be used on open wounds.
Silicone Gels: Clean the scar area before use. Apply a thin layer twice daily. Allow the gel to dry before dressing. Discontinue use if any allergic reaction occurs.
Contraindications: Do not use on open wounds or infected areas.

Clinical Experience Sharing

Dr. Shiou-Han Wang’s clinical experience shows that silicone products are highly effective in treating severe scars. In particular, for hypertrophic scars and keloids, silicone products serve as an excellent adjunctive therapy and should be used in combination with other treatment modalities, such as cryotherapy, corticosteroid injections, pulsed dye laser, or botulinum toxin injections.

Case Presentation

Before Treatment: Scar is prominent, with thickened tissue.
During Treatment: Silicone products are used in conjunction with other therapies, with ongoing monitoring.
After Treatment: Significant scar reduction, smoother skin, and remarkable improvement.

Conclusion

Silicone products offer a scientifically proven, non-invasive method for scar treatment. Early intervention and consistent use are key to success. Choosing the right product for the specific scar type and combining it with other treatments will help achieve the best results.