Efficacia e tollerabilità di un gel a base di Allium cepa ed allantoina nei processi di cicatrizzazione di ferite chirurgiche

Background: Cutaneous scars resulting from surgical procedures can be erythematous, hypertrophic, pruritic, painful, or cosmetically unacceptable. Recently an onion extract-based topical gel has been employed to improve scar appearance and texture. However, few studies are available about its efficacy, with contrasting results. Objective: To evaluate the effectiveness of a topical onion extract gel (Mederma®) in improving the appearance and symptomatology of postsurgical scars compared with a topical emollient ointment. Methods: Using a randomized, double-blinded study design, thirty patients with surgical scars resulting from cesarean section were assigned to 1 or 2 groups on the 10th day of suture removal. Each group applied a designated topical product (group 1: onion gel; group 2: emollient ointment) 3 times a day, for 12 weeks, and patients were evaluated at enrollement and after 7 and 12 weeks following initiation of treatment. Photographic documentation and clinical evaluation using a visual analog scale were completed for each scar enrolled in the study. Results: Scars were evaluated by blinded investigators for erythema, hypertrophy and symptoms (itch, burning and pain). Patients treated with gel showed a significant reduction of erythema and hypertrophy between pretreatment and posttreatment evaluations with respect to those treated with topical emollient. However, no statistically significant difference (p<0.06) was found between the two groups in any of the outcome variables studied. Gel was well-tolerated with high rate of satisfaction expressed by patients. Conclusion: The onion extract gel demonstrates its efficacy to improve the appearance and symptomatology of post-surgical scars after the treatment period, with no side effects. Some patients may not respond to single treatment modality, and the association of multiple treatment modalities may be the best approach for maximizing therapeutic success.