Using a Silicone Gel Prosthesis for Burn Scar Camouflage: A Case Report.

Abstract

The scarring that occurs following a burn injury can have devastating physical and emotional consequences for the patient. Scar revision surgery can be very effective, but when surgical options are exhausted or the patient declines, camouflage is an alternative. A 43-year-old woman with mid-deep dermal flame burns sustained in a house fire in August 2020, comprising 6% total body surface area, underwent chemical debridement followed by allograft application. One month later, the patient underwent surgical debridement with a split-thickness skin graft to an unhealed area on her left posterior shoulder. This procedure was successful, with 100% graft take. During her follow-up visits, she developed hypertrophic scarring in this region, which shifted the focus of her care to scar management. We developed a custom-made silicone gel prosthesis to camouflage the scar, help the patient regain confidence, and also provide therapeutic benefit by sealing in hydration. The prosthesis was matched to the patient's normal skin tone and texture, featuring a soft and flexible outer surface with a smooth inner surface for adherence. The patient found the prosthesis easy to apply and inconspicuous, yet effective at concealing the scarred area. The prosthesis also offered protection from external sources of irritation. Both the Patient and Observer Scar Assessment Scale and the Modified Vancouver Scar Scale showed marked improvement when the prosthesis was used.