Patients undergoing breast reduction or mastopexy surgery will be screened and recruited for participation in the study. Eligible patients will act as their own control with one breast receiving the active intervention (ChitoCare® medical Scar Healing Gel) and the other receiving standard of care (Amoena CuraScar Mammilla Circles Silicone Scar Patch and Amoena CuraScar Anchors Silicone Scar Patch). The active and control interventions will be applied for six months, and participants will be followed for up to 12 months. The scar properties of each breast will be assessed at study initiation (Day 0) and at study visits at 3, 6, 9, and 12 months using the Patient and Observer Scar Assessment Scale (POSAS) and via blinded assessment of photographs. Other subjective parameters such as pain, itching, and overall perception of the healed wound will be collected at each study visit via the POSAS, and patients' opinion, preferences, and compliance regarding the treatments will be collected via a basic questionnaire.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
39
ChitoCare® medical Scar Healing Gel is a topical gel indicated for the treatment of new and old scars. The Scar Healing Gel provides a soothing effect and support to the scar tissue to heal in an orderly manner. It protects against infections, stimulates cell proliferation in old and new scars, as well as correct tissue organization with proper collagen alignment for a better aesthetic appearance and skin flexibility. Ideal for treating scars after accidents, surgery, C-section and cosmetic surgery. For smoother and less visible scars. May be used by the whole population, also elderly and children.
Amoena CuraScar Mammilla Circles Silicone Scar Patch and Amoena CuraScar Anchors Silicone Scar Patch are silicon-based, single-patient, multi-use scar patches intended for use as scar reduction therapy in surgical breast scars. The silicone creates a moist environment on the scar, which prevents the scar from drying out. It keeps the scar soft and has a positive effect on scar tissue. The devices are specifically designed for breast scarring and are shaped to fit the normal surgical scars experienced after breast surgery.
Klíníkin Ármúla
Reykjavik, Capital Region, Iceland
Comparison of scar assessment at 12 months
Comparison of the subjective assessment of scar appearance using the Patient and Observer Scar Assessment Scale 3.0 (POSAS) in active vs control group at 12-months post-surgery. The POSAS 3.0, for both the Patient Scale and the Observer Scale, rates each individual item on a 5-point scale. The minimum value for an item is 1, which corresponds to a scar characteristic or sensation that is like normal skin (a better outcome). The maximum value for an item is 5, which indicates the largest difference from normal skin or the worst imaginable scar characteristic or sensation (a worse outcome). The total score for the Patient Scale and the Observer Scale is calculated by summing the scores of the individual items within each scale. Consequently, for the POSAS 3.0, a higher total score on either the Patient Scale or the Observer Scale signifies a worse scar outcome or a greater severity of scar-related issues from that perspective.
Time frame: 12 months post-surgery
Comparison of scar assessment at 3, 6, and 9 months
Comparison of the subjective assessment of scar appearance using the Patient and Observer Scar Assessment Scale (POSAS) in active vs control group at 3, 6, and 9 months post-surgery. The POSAS 3.0, for both the Patient Scale and the Observer Scale, rates each individual item on a 5-point scale. The minimum value for an item is 1, which corresponds to a scar characteristic or sensation that is like normal skin (a better outcome). The maximum value for an item is 5, which indicates the largest difference from normal skin or the worst imaginable scar characteristic or sensation (a worse outcome). The total score for the Patient Scale and the Observer Scale is calculated by summing the scores of the individual items within each scale. Consequently, for the POSAS 3.0, a higher total score on either the Patient Scale or the Observer Scale signifies a worse scar outcome or a greater severity of scar-related issues from that perspective.
Time frame: 3, 6, and 9 months post-surgery
Improvement in subjective assessment of scar tissue
Improvement of the subjective assessment of scar tissue between Day 0 and 3, 6, 9, and 12 months using the POSAS in active vs control arm. The POSAS 3.0, for both the Patient Scale and the Observer Scale, rates each individual item on a 5-point scale. The minimum value for an item is 1, which corresponds to a scar characteristic or sensation that is like normal skin (a better outcome). The maximum value for an item is 5, which indicates the largest difference from normal skin or the worst imaginable scar characteristic or sensation (a worse outcome). The total score for the Patient Scale and the Observer Scale is calculated by summing the scores of the individual items within each scale. Consequently, for the POSAS 3.0, a higher total score on either the Patient Scale or the Observer Scale signifies a worse scar outcome or a greater severity of scar-related issues from that perspective.
Time frame: 3, 6, 9, and 12 months post-surgery
Blinded assessment of scars
Comparison of scar appearance at 3, 6, 9, and 12 months as judged by blinded assessment of photographs of active vs control intervention using the modified Stony Brook Scar Evaluation Scale (mSBSES). For the modified SBSES, the scoring is structured such that higher scores indicate a better cosmetic outcome or less noticeable scarring. Scar width, height, colour, and presence of incision line are rated on a scale for 0-2, where 0 indicates a worse outcome, and 2 indicates similarity to normal skin. The best possible score is therefore 8, and worst outcome is 0.
Time frame: 3, 6, 9, and 12 months post-surgery
Comparison of pain, discomfort, itching, and range of motion
Comparison of pain or discomfort, itching, range of motion etc. between the groups as captured by the POSAS at 3, 6, 9, and 12 months. The POSAS 3.0, for both the Patient Scale and the Observer Scale, rates each individual item on a 5-point scale. The minimum value for an item is 1, which corresponds to a scar characteristic or sensation that is like normal skin (a better outcome). The maximum value for an item is 5, which indicates the largest difference from normal skin or the worst imaginable scar characteristic or sensation (a worse outcome). The total score for the Patient Scale and the Observer Scale is calculated by summing the scores of the individual items within each scale. Consequently, for the POSAS 3.0, a higher total score on either the Patient Scale or the Observer Scale signifies a worse scar outcome or a greater severity of scar-related issues from that perspective.
Time frame: 3, 6, 9, and 12 months post-surgery
Adverse events
Incidence of adverse events between arms
Time frame: 12 months post-surgery
Comparison of treatment compliance
Participants will be asked at 3 months and 6 months post-surgery how they would rate their compliance to each treatment (arm) via a basic questionnaire: a 5-point rating system will ask whether participants used/wore their treatment every day as recommended, most days but not always, only sometimes, rarely, or hardly ever/did no comply to treatment. Scores between the 2 arms will be compared for trends for treatment compliance.
Time frame: 6 months post-surgery
Cost comparison of treatments
Cost of active vs control treatment in relation to outcomes over 6 months
Time frame: 6 months post-surgery
Patient treatment preference
Participants will be asked which treatment they preferred (i.e., active vs control treatment) via a questionnaire at 3 and 6 months
Time frame: 3 and 6 months post-surgery
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