Network Meta-Analysis of Different Clinical Commonly Used Drugs for the Treatment of Hypertrophic Scar and Keloid

Background: There is no uniform treatment for pathological scars, including keloids and hypertrophic scars, in clinic currently. Previously, multiple randomized controlled trials have examined the clinical efficacy of different treatments. Nonetheless, the results are inconsistent, and many treatments have not been directly compared. This makes it difficult to conclude which approach is more favorable, in terms of efficacy and safety, for the treatment of pathological scarring. This study aimed at evaluating the efficacy of different injection and topical treatment strategies for hypertrophic scar and keloid.Methods: Relevant literature from PubMed, Medline, Embase, Scopus, the Cochrane Central Register of Controlled Trials (CCRCT), and WHO International Clinical Trials Registry Platform (WHO-ICTRP) were searched, from database inception through November 2020. Randomized clinical trials evaluating different treatment strategies of pathological scars, including triamcinolone acetonide (TAC), verapamil (VER), 5-fluorouracil (5-FU), botulinum toxin A (BTA), bleomycin (BLM), and silicone gels were included in the study.Results: The network meta-analysis included a total of 2,009 patients from 29 studies. A network meta-analysis of injection and topical treatment strategies showed that the efficacy of TAC combined with BTA was best in the treatment of pathological scars. Combination therapies of TAC with 5-FU and TAC with BTA significantly improved the clinical efficiency. However, there was no statistically significant difference between other treatment strategies. The order of efficacy predicted by the surface under the cumulative ranking (SUCRA) curve was as follows: TAC+BTA (82.2%) > TAC+5-FU (69.8%) > BTA (67.3%) > 5-FU+silicone (59.4%) > TAC+silicone (58.3%) > 5-FU (49.8%) > BLM (42.0%) > TAC (26.7%) > VER (26.2%) > silicone (18.3%). There was no publication bias revealed based on the funnel diagram.Conclusion: This study recommends intralesional injection of TAC-BTA and TAC-5-FU combined therapies. But for patients who cannot tolerate the side effects, the use of silicone gels in combination with TAC is recommended. However, these conclusions need to be further confirmed by more randomized controlled trials.

Macroporous Silicone Sheets Integrated with Meshes for Various Applications

Flexible macroporous silicone gels were prepared using methyltrimethoxysilane and dimethyldimethoxysilane as co-precursors via a two-step reaction catalyzed by acetic acid and ammonia solution. A sheet-shaped material was integrated with the gel by immersing the mesh in the sol during the reaction. The mesh reinforced sheet having a thickness of several millimeters was resistant to bending and pulling and easy to handle. The composite sheet was used for various applications such as water-oil separation, manipulation of water droplets by adsorption on the hydrophobic surface, and preparation of giant vesicle dispersion.

Macroporous Silicone Sheets Integrated with Meshes for Various Applications

Flexible macroporous silicone gels were prepared using methyltrimethoxysilane and dimethyldimethoxysilane as co-precursors via a two-step reaction catalyzed by acetic acid and ammonia solution. A sheet-shaped material was integrated with the gel by immersing the mesh in the sol during the reaction. The mesh reinforced sheet having a thickness of several millimeters was resistant to bending and pulling and easy to handle. The composite sheet was used for various applications such as water-oil separation, manipulation of water droplets by adsorption on the hydrophobic surface, and preparation of giant vesicle dispersion.

Characterization of Silicone Gel for High Temperature Encapsulation in High Voltage WBG Power Modules

One of the most important advantages of wide-bandgap (WBG) devices is high operating temperature (>200°C). Power modules have been recognized as an enabling technology for many industries, such as automotive, deep-well drilling, and on-engine aircraft controls. These applications are all required to operate under some form of extreme environmental conditions. Silicone gels are the most popular solution for the encapsulation of power modules due to mechanical stress relief enabled by a low Young's modulus, electrical isolation achieved due to high dielectric strength, and a dense material structure that protects encapsulated devices against moisture, chemicals, contaminants, etc. Currently, investigations are focused on development of silicone gels with long-term high-temperature operational capability. The target is to elevate the temperature beyond 200°C to bolster adoption of power modules in the aforementioned applications. WACKER has developed silicone gels with ultra-high purity levels of < 2ppm of total residual ions combined with > 200°C thermal stability. In this work, leakage currents through a group of WACKER Chemie encapsulant silicone gels (A, B, C) are measured and compared for an array of test modules after exposure to a 12kV voltage sweep at room temperature up to 275°C, and thermal aging at 150°C for up to more than 700 hours. High temperature encapsulants capable of producing leakage currents less than 1μA, are deemed acceptable at the given applied blocking voltage and thermal aging soak temperature. To fully characterize the high temperature encapsulants, silicone gel A, B, and C, an entire high temperature module is used as a common test vehicle. The power module test vehicle includes: 12mil/40mil/12mil Direct Bonded Copper (DBC) substrates, gel under test (GUT), power and Kelvin connected measurement terminals, thermistor thermal sensor to sense real-time temperature, and 12mil Al bonding wires to manage localized high E-Fields around wires. It was ultimately observed that silicone gels B and C were capable of maintaining low leakage current capabilities under 12kV and 275°C conditions, and thus present themselves as strong candidates for high-temperature WBG device power modules and packaging.