ABSTRACT:Introduction: Children treated for cancer with a central venous
catheter are often bothered by scarring. We studied whether
glucocorticosteroid during patch occlusion has a beneficial effect on
scar outcome in children and adolescents treated for neoplastic disease.
Methods: A double-blinded placebo-controlled randomized
clinical trial was performed. The main outcome was the Vancouver Scar
Scale (VSS). Secondary outcomes were scar width and scar quality
measured using the Patient and observer scar assessment (POSAS). The
patients were divided into an intervention groups and a control group.
The intervention group was randomized into two groups; Active and
placebo group. The active treatment consisted of cream with
glucocorticosteroid and fusidic acid. The placebo treatment consisted of
cream with fusidic acid. Both groups were also treated with a silicone
gel patch for three months after central venous catheter removal. The
control group did not receive any specific skin care.
Results: Assessment at 6 months were completed for 44 in the
intervention group (21 in the active and 23 in the placebo group) and 47
in the comtrol group. The intervention group had a significantly lower
VSS and a smaller scar compared to the control group (p = 0.00, p =
0.02). The POSAS by the patients and the study nurse showed no
significant difference between the intervention and control groups (p =
0.84, p= 0.36).
Conclusions: Silicone gel sheet alone or in combination with
application of glucocorticosteroid during sheet occlusion improved scar
outcome after removal of central venous catheter in children treated for
neoplastic diseases.