{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:27:49Z","timestamp":1771489669363,"version":"3.50.1"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,2,24]],"date-time":"2014-02-24T00:00:00Z","timestamp":1393200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Linear hypertrophic scarring is a common surgical problem that can be difficult to manage. This article evaluates median sternotomy wounds that have often been reported to scar poorly resulting in hypertrophic scar formation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is a single\u2010blinded, open\u2010labelled pilot study of 20 patients using keratin gel as the intervention and aqueous cream as the control, which are each applied to a different half of the wound daily over 6 months. We use the <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>atient and <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>bserver <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>car <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ssessment <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cale (<jats:styled-content style=\"fixed-case\">POSAS<\/jats:styled-content>) and the <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>anchester <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>car <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>core (<jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content>) to assess the scarring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the 6\u2010month assessment the <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content>, patient\u2010<jats:styled-content style=\"fixed-case\">POSAS<\/jats:styled-content> and observer\u2010<jats:styled-content style=\"fixed-case\">POSAS<\/jats:styled-content> were 12.00, 16.70 and 15.00 in the treatment half and 12.58, 17.85 and 16.55 in the control half respectively. Overall, we found that there was a decrease in all score scales after 6 months (<jats:italic>P<\/jats:italic> = 0.005). Furthermore, in the subset of patients with poor scarring, decreases in the <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content>, patient\u2010<jats:styled-content style=\"fixed-case\">POSAS<\/jats:styled-content> and observer\u2010<jats:styled-content style=\"fixed-case\">POSAS<\/jats:styled-content> were statistically significant (<jats:italic>P<\/jats:italic> = 0.025, &lt;0.01 and 0.01) with scores of 12.22, 17.33 and 15.33 in the treatment half and 14.22, 23.67 and 22.33 in the control half respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients who scar more poorly than average, there were significant improvements in scarring. This demonstrates a simple, well\u2010tolerated intervention that reduces problematic scarring following surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.12520","type":"journal-article","created":{"date-parts":[[2014,2,24]],"date-time":"2014-02-24T18:08:05Z","timestamp":1393265285000},"page":"378-380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Keratin gel improves poor scarring following median sternotomy"],"prefix":"10.1111","volume":"85","author":[{"given":"N. 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