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. 2013 Sep 12;2013(9):CD003826. doi: 10.1002/14651858.CD003826.pub3

Colom Majan 2006.

Methods RCT
Participants Special Sciences Institute, Spain
 11 patients
 Inclusion criteria: adults > 18 years with postoperative scars
 Exclusion criteria: underlying relevant disease, known hypersensitivity to product used; inability to comply/attend follow‐up; keloid scar
 Sex: all female
 Age: 20 to 43
Interventions silicone gel sheeting applied to 6 scars for 23 hours per day for a maximum of 1 week; 5 controls had no treatment
Outcomes Length of follow‐up: measurements made at monthly intervals for 6 months, then at 12 months
 Clinical: Vancouver scale for appearance; patient's rating of pain and itch 
 Complications: local skin reaction
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: “participants were randomly allocated to one of the two treatment options by a predetermined computer generated randomisation list”.
Comment: participants were judged to be adequately randomised
Allocation concealment (selection bias) Unclear risk Comment: no information on allocation concealment was given in the study which was judged to be at unclear risk
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Quote: “Blinding was not possible as this was a dressing versus no dressing study”.
Comment: the study was described as “an open randomised controlled clinical investigation”. Due to the nature of the treatment, we judged that participants and personnel could not be blinded.
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Comment: no further information was given on blinding of outcome assessor which we judged to be at unclear risk of bias
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Quote: “Eleven female patients were randomised and enrolled . . . ten participants completed the 12‐month investigation; one in the treatment group discontinued for personal reasons.”
Comment: we judged attrition bias to be low
Selective reporting (reporting bias) Low risk Comment: the study protocol was not sought, however all measurements discussed in the methods are reported in the results and clinically meaningful outcomes presented.
Other bias High risk Quote: “This study was supported by Molnlycke Healthcare AB”.
Comment: Molnlycke Healthcare AB was the brand of silicone gel used in the trial. We judged this to cause a high risk of bias.