Mepiform® Clinical Cases

• Burn Scar, Emilio Serrato, Minor Surgery Unit, Cruz de Humilladero Health Center, Málaga, Spain.
• Trauma Scar, Berta Montaner Farrera, Hospital de Igualada, Barcelona, Spain
• Laceration Scar, Frans Meuleneire, W.C.C. St. Elisabeth Zottegem, Belgium
• Incision Scar, Emilio Serrato, Cruz de Humilladero Health Center, Minor Surgery Unit, Málaga, Spain
• Burn Scar, Belén Gómez Gil, Plastic Surgery Unit, Son Dureta University Hospital, Majorca, Spain
• Post-Nevus Surgery Scar, Burn Scar, Emilio Serrato, Cruz de Humilladero Health Center, Minor Surgery Unit, Málaga, Spain
• Trauma Wound, Yolanda Guillén Beltrán, Virgen de la Victoria University Hospital, Málaga, Spain
• Scalding Scar, Manuel Gago Fornells & Fernando García González, Puerto Real Hospital, Cádiz, Spain
• Post-Carcinoma Surgery Scar, Belén Gómez Gil, Plastic Surgery Unit, Son Dureta University Hospital, Majorca, Spain
• Post-Carcinoma Surgery Scar, Yolanda Guillén Beltrán, Virgen de la Victoria University Hospital, Málaga, Spain
• Burn Scar, Elodia Dumont Lupiañez and José Maria Carrasco Herrero, Ronda-Sur Health Center, Málaga, Spain
• Cheekbone Laceration Scar, Inmaculada Carrera Illera and Antonia Odena Oliva, Brain Damage Unit, Dr. Moliner Hospital, Valencia, Spain
• Liposuction and Abdominoplasty Scar, Ana María Bastias Sarmiento, Esporlas Health Center, Majorca, Spain
• Burn Scar, Lourdes Ruiz España, El Palo Health Center, Málaga, Spain
• Scalding Scar, Miguel Javier Martínez Varón and José Carrión Sánchez, Caniles Practice, Granada, Spain
• Scar Following Cardiopathy Surgery, Belén Gómez Gil, Plastic Surgery Unit, Son Dureta University Hospital, Majorca, Spain

Case Study 1 : Burn Scar

Emilio Serrato, Minor Surgery Unit, Cruz de Humilladero Health Center, Málaga, Spain

A 33-year-old woman with no previous disorders. She suffered a second-degree burn to the outer ankle bone of the left leg, from oil. This received moist treatment, and after infection the wound took around 8 weeks to heal.

One week after healing, a keloid appeared in the area of the burn, measuring roughly 2 cm x 2 mm x 2 mm, with stabbing pain and itching, as well as distress due to its unattractive appearance.

Development: Graphite Homaccord infiltration treatment was used on the wound every 3 days for two weeks. At the same time, steroid cream was administered twice a day for one week, as concomitant treatment to the infiltrations.

When the infiltrations ended, treatment was begun with Mepiform®, inspecting the area every 24 hours and reusing the same dressing until it lost its adhesion. The dressing was changed every 7 days on average, with a new dressing cut for the scar after this period of time.

The total duration of treatment was 8 weeks. Rosehip oil was then used until the scar healed completely.

There were no adverse reactions or skin irritation around the wound at any time.

Case Study 2: Trauma Scar

Berta Montaner Farrera, Hospital de Igualada, Barcelona, Spain

53-year-old patient hit by an automobile. The emergency diagnosis was Traumatic Brain Injury. A brain CT showed no traumatic lesions, and recovery was relatively fast. Contusion to the shoulder and large lacerated contused wound to the right forearm.

 Surgical cleansing was carried out in the E.R. More than 40 stitches were needed, and a Penrose drain was inserted. There was no vascular-nervous involvement. Once the patient’s overall condition had stabilized, he was discharged and treated as an outpatient. We were presented with a traumatic contused wound to the right forearm, of substantial size and depth, which required various treatments over several weeks. As healing advanced, we were in no doubt as to the need to apply effective treatment to correct the rigidity, tautness, grooving, etc. of the scar.

Development: Development was favorable although, due to the nature of the wound, complete epithelialisation took two months from the time of the injury.

 This was when treatment with a Mepiform® dressing was begun. The dressing was changed every 10–12 days, and the patient wore it 24 hours a day.

There was soon evidence of a reduction in thickness, smoothness to the touch, greater flexibility, and over time a reduction in the initial grooving and unevenness of the scar.

Case Study 3: Laceration Scar

Frans Meuleneire, W.C.C. St. Elisabeth Zottegem, Belgium

A 24-year-old woman suffered a severe laceration to the forehead and right supraorbital area as a result of a motorcycle accident. After moist treatment using Mepitel ® for 10 days to close the wound, there was a hypertrophic keloid scar, leaving the patient very anxious about its appearance.

Mepiform ® treatment was begun. During treatment, the patient did not report any pain when the dressing was removed, and treatment was discreet because the dressing was the same colour as her skin. Also, as it was waterproof, she was able to shower and lead a normal life. The dressing was changed every 10 days on average.

Development: After four months’ treatment there was already a significant change in the texture and coloring of the scar.

After seven months, the scar was flat, with only isolated areas of pigmentation. After 11 months, pigmentation had almost disappeared, and the patient was very pleased with the final appearance.

Case Study 4: Incision Scar

Emilio Serrato, Cruz de Humilladero Health Center, Minor Surgery Unit, Málaga, Spain

A 34-year-old woman with an incision wound to the leg, treated at her health centre using a Sterip-strip. Wound healing was complicated by infection, and full healing took around three weeks.

A keloid measuring 4 cm x 2 mm x 2 mm appeared after around 6 months, with no itching or stinging.

Development: Mepiform ® treatment was begun in the year in which the keloid appeared, leaving a 0.5 mm overlap around the area treated. The dressing was removed every 24 hours and the same dressing was reapplied, each one lasting an average of 2 weeks. Treatment lasted for 6 months, and the patient then continued with rosehip oil.

 The patient did not report any irritation or problems using the dressing. The treatment was very well tolerated.

Case Study 5: Burn Scar

Belén Gómez Gil, Plastic Surgery Unit, Son Dureta University Hospital, Majorca, Spain

A 15-month-old patient scalded on December 15, 2006, causing first- and second-degree burns to the left upper limb. This resulted in a substantial scar on the hand, and a skin graft was required on the forearm, carried out on April 10, 2007.

Development: Mepiform ® treatment of the wound was begun on April 24, 2007. After the first fifteen days, both scars had improved considerably.

Finally, 2 months, 9 days later (11 weeks of treatment), the appearance of the scars had greatly improved. The hypertrophy and pigmentation of the scar on the hand had disappeared. On the forearm, the hypertrophy had disappeared and the scar had faded significantly.

There was no pain at any time when dressings were removed. There were no allergic reactions, and the dressing was easy to apply and reuse.

Case Study 6: Post-Nevus Surgery Scar

Emilio Serrato, Cruz de Humilladero Health Center, Minor Surgery Unit, Málaga, Spain

A 27-year-old woman who underwent surgery for a nevus on her left shoulder blade subsequently presented a hypertrophic scar measuring 1.2 cm x 1 cm x 2 mm. The scar caused stabbing pain, and was also painful when rubbed. One year after surgery, she consulted a doctor and was referred to the Minor Surgery Unit.

Development: Injectable Graphite Homaccord solution treatment was begun, infiltrated into the lesion. At the same time treatment with steroid cream was administered for one week.

 The week following steroid treatment, Mepiform ® treatment was begun. The patient reports that the scar was no longer painful when rubbed, and there was no more stabbing pain. There was significant reduction in hypertrophy until treatment was ended after 2 months.

 Inspection of the area every 24 hours was prescribed, reusing the same dressing while it remained adhesive. The dressing was changed on average once a week, with no reddening or irritation caused by the dressing in the area around the lesion. The patient did not report any pain when the dressing was changed. The dressing required no additional fixation.

Case Study 7: Trauma Wound

Yolanda Guillén Beltrán, Virgen de la Victoria University Hospital, Málaga, Spain

A 37-year-old patient with a trauma wound to the left of the forehead, causing unevenness in the skin in this part of the forehead. Mass suturing was carried out, causing an atrophic scar after the stitches were removed. The area was indurated, with altered pigmentation and raised skin.

The patient displays a psychological complex due to an altered body image.

Treatment: Mepiform ® silicone dressing treatment was begun after stitches were removed.
Treatment duration: 1 year.

 Application: There were no problems on application, as this is simple for the patient and for the treating physician. The patient was taught to apply the dressing herself at any time, and to remove it when it lost its adhesion.

Contraindications: No adverse reactions to treatment were observed. There was no itching, irritation or rash in the area treated or the surrounding area.

Case Study 8: Scalding Scar

Manuel Gago Fornells, Puerto Chico Health Center, Cádiz, Spain
Fernando García González, Puerto Real Hospital, Cádiz, Spain

A 62-year-old woman scalded in a household accident. She had first-degree burns to the neck and face, superficial second-degree burns to the hands and abdomen and deep second-degree burns to the breasts and abdomen.

After treatment with Mepitel ® and silver sulfadiazine, Mepiform ® treatment was begun to reduce the resulting scar.

Development: After 6 months’ treatment, positive development of the scar was observed. Treatment was continued up to 12 months, achieving a clear improvement in appearance which improved the patient’s self-esteem.

Case Study 9: Post-Carcinoma Surgery Scar

Belén Gómez Gil, Plastic Surgery Unit, Son Dureta University Hospital, Majorca, Spain

A 38-year-old woman who underwent surgery in June 2006 for a breast carcinoma, after which she received several radiotherapy sessions. As a result of the surgery she presented a pigmented hypertrophic scar with various depressions created by stitches, resulting in psychological distress due to the adversely affected appearance of the area.

Development: 8 months after surgery, Mepiform® treatment was begun.

The patient did not report any pain when the dressing was removed. She reported ease of use and reuse of the dressing.

 After 4 months of treatment, the area treated was much more discreet in appearance. The scar had flattened and was much less noticeable than before treatment. The patient was very pleased with the aestetic result of treatment.

Case Study 10: Post-Carcinoma Surgery Scar

Yolanda Guillén Beltrán, Virgen de la Victoria University Hospital, Málaga, Spain

A 19-year-old patient who had undergone emergency surgery for appendicitis with continuous reabsorbable stitching. Good clinical development of patient, no complications after surgery.

Once the stitches had been reabsorbed, the patient presented a keloid scar at the site of surgery, with significant pigmentation. The site also showed slight hypertrophy.

Development: Mepiform ® treatment was begun in January 2009 due to altered body image, which affects the patient as a reduction in her own physical perception of herself.

Throughout treatment application was convenient and simple, and easy for the patient herself and the researcher to handle. The patient stated that she found it very easy to carry out the treatment. She said she was very pleased with the aesthetic results achieved. There were no complications in the form of pain or discomfort at any time, either with the dressing in place or when it was removed. There was no alteration in the area around the scar, and no allergic reaction to the treatment.

 After six months of treatment the keloid had completely flattened and the pigmentation of the whole sutured area had decreased. The skin in the area was the same color as the surrounding skin.

Case Study 11: Burn Scar

Elodia Dumont Lupiañez and José Maria Carrasco Herrero, Ronda-Sur Health Center, Málaga, Spain

A 33-year-old patient diagnosed with HBP who in March 2005 suffered a household accident when a butane cylinder exploded, leaving the patient with burns to the right hand and arm. She was transferred to the Burns Unit of the Carlos Haya Hospital in Málaga. where after the lesion was assessed and treated she was referred to her health centre to continue treatment of the affected hand, and later on to consider the possibility of a skin graft on her index finger.

She was cared for at the nursing station of her health centre for the lesions on her index, middle, ring and little fingers, the back of her hand and her right arm.

Development: After various months of treatment, due to the positive development of her injuries, the Burns Unit decided not to carry out a skin graft, and the patient continued treatment in the Primary Care Unit until the burn had healed. After the injuries had epithelialised, a large keloid remained on the arm, the back of the hand and the fingers. We began treating this with Mepiform ® from June 27, 2005 to December 15, 2005.

During treatment, the patient reported good tolerance of Mepiform ®. Dressing changes were painless, with no irritation of the scar or the skin around it. It was also convenient to use, even though the area treated was in constant movement. The patient was very pleased with the resulting appearance.

Case Study 12: Cheekbone Laceration Scar

Inmaculada Carrera Illera and Antonia Odena Oliva, Brain Damage Unit, Dr. Moliner Hospital, Valencia, Spain

A 6-year-old outpatient of the hospital who suffered a household accident in November 2008 when she hit the windows of her house with her knee, breaking them. Glass from the top part of the windows fell onto her face, cutting the area around her right cheekbone and leaving a wound with a skin flap in the shape of a figure 7.

 She was treated at the E.R. of La Fe Hospital, Valencia, where she was given intradermal suturing via plastic surgery.

Development: Mepiform ® treatment was begun in January 2009 and ended in June. Throughout treatment, sun protection was applied before the dressing to protect the scar, due to the high level of solar radiation in the area where the patient lives.

The Mepiform ® laminate was changed every four days, as the patient attends swimming lessons.

Case Study 13: Liposuction and Abdominoplasty Scar

Ana María Bastias Sarmiento, Esporlas Health Center, Majorca, Spain

A 32-year-old woman who had suffered eventration at an abdominal scar after liposuction and abdominoplasty with intradermal stitches on February 4, 2009. A very dark keloid developed, with irregular, somewhat hypertrophic edges of the resulting scar.

Development: Mepiform ® treatment was begun on March 20, 2009. Due to the excellent results being achieved, treatment was continued in July 2009 until the end of September.

The patient reported that the product is very easy to use, and did not experience any pain when the dressing was changed or reaction in the scar or surrounding skin. She is very pleased with the appearance achieved, as the keloid is now paler.

The evaluating nurse reports that the Mepiform ® treatment was very effective, as the patient was anxious about the aesthetic results of surgery. After it was explained how treatment should be carried out, she described this as very easy for the patient. Examinations of the scar have not revealed any alterations to it or to the surrounding skin. The patient did not report any pain when the dressing was changed, which was done every 10 days.

Case Study 14: Burn Scar

Lourdes Ruiz España, El Palo Health Center, Málaga, Spain

A 28-year-old male patient with a left periorbital posttraumatic scar after falling off his bicycle on March 19, 2003.

After the wound had healed, there was a hypertrophic keloid scar with considerable erythema around the lesion and uneven areas within and around the scar.

Mepiform ® treatment was begun in May, with an average of 5 days’ use for each dressing. Although this is an area of the anatomy which is difficult to cover with a dressing, the patient does not report any discomfort during treatment, and he found the dressings easy to apply. As it is a thin, flexible laminate, he did not report any discomfort during his daily activities due to the dressing.

Development: After 5 months (22 weeks) of treatment, there is a clear aesthetic improvement. The scar is now uniform, with no hypertrophy remaining and significantly reduced reddening of the keloid.

The patient reports that he is very pleased with the treatment, because the appearance of the scar has improved significantly

Case Study 15: Scalding Scar

Miguel Javier Martínez Varón and José Carrión Sánchez, Caniles Practice, Granada, Spain

A 57-year-old woman with second-degree burns due to scalding on July 5, 2008. She was treated in the E.R. with antitetanus prophylaxis, analgesic and antibiotic treatment, phlyctenae were evacuated and she was given topical Furacin-type gas treatment.

This treatment was abandoned at her primary care centre. Sterile phlyctena debridement was prescribed, with Mepitel ® as primary dressing. After 2 days the lesion was reassessed after wound cleaning, and shows a clean wound bed with slight exudate. The dressing was replaced with Mepilex® Lite to handle the exudate and avoid the patient’s clothing rubbing against the wound.

Development: The patient presented large areas of pigmentation. It was decided to begin treating the various burnt areas with Mepiform ®.

After one and a half months of Mepiform ® treatment, there was a major reduction in the reddening of the wounds. The patient did not report any discomfort when the dressing was changed, or any skin problems in the areas treated with the product. 

In the opinion of the nursing staff who assessed the treatment, prompt Mepiform ® treatment significantly reduces the pigmentation of burns, resulting in increased self-esteem and quality of life for patients.

Case Study 16: Scar Following Cardiopathy Surgery

Belén Gómez Gil, Plastic Surgery Unit, Son Dureta University Hospital, Majorca, Spain

A 56-year-old woman who had undergone thoracic surgery for cardiopathy. The operation was carried out in July 2006.

After surgery a large keloid was observed, accompanied by hypertrophy. This was very traumatic for the patient, due to its unattractive appearance. Eight and a half months later, after recovery from surgery, Mepiform ® treatment was begun.

Development: The patient was shown how to apply Mepiform® to the affected area so that she can continue treatment herself. At 15 days there is already a reduction in the hypertrophy of the scar.

After 3 months of treatment, the hypertrophy had decreased considerably, as had the pigmentation of the keloid, particularly at the centre of the scar.