human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Ointments ( e.g. , petrolatum ) are thought to be occlusive , thereby blocking transcutaneous water loss and trapping water under the skin 's surface . If this premise is correct , then petrolatum should delay barrier recovery after barrier perturbation , as shown previously in occluded murine skin . OBJECTIVE We reexamined the assumption that Vaseline Petroleum Jelly ( VPJ ) is occlusive , ascertaining both its site and mechanism of action . METHODS Barrier recovery was measured in VPJ-treated versus untreated sites after acetone-induced barrier disruption in human volunteers . Moreover , VPJ was localized within the stratum corneum ( SC ) with tracers and ruthenium tetroxide staining , which allowed visualization of the depth of VPJ penetration and its relation to intercellular membrane structures . RESULTS VPJ accelerated , rather than impeded , barrier recovery . Moreover , VPJ was present within the interstices at all levels of the SC , where it replaced intercellular bilayers . CONCLUSION VPJ neither forms nor acts like an epicutaneous impermeable membrane ; instead , it permeates throughout the SC interstices , allowing normal barrier recovery despite its occlusive properties PURPOSE To evaluate and characterize the wound healing process profile induced by allantoin incorporated in soft lotion oil/water emulsion using the planimetric and histological methods . METHODS Female Wistar rats ( n=60 ) were r and omly assigned to 3 experimental groups : ( C ) control group-without treatment ; ( E ) group treated with soft lotion O/W emulsion excipients ; ( EA ) group treated with soft lotion O/W emulsion containing allantoin 5 % . The emulsions either containing or not allantoin were topically administered for 14 days and the wound area was evaluated by planimetry and by qualitative and quantitative histological analysis of open wound model . RESULTS The data which were obtained and analyzed innovate by demonstrating , qualitatively and quantitatively , by histological analysis , the profile of healing process induced by allantoin . The results suggest that the wound healing mechanism induced by allantoin occurs via the regulation of inflammatory response and stimulus to fibroblastic proliferation and extracellular matrix synthesis . CONCLUSION This work show , for the first time , the histological wound healing profile induced by allantoin in rats and demonstrated that it is able to ameliorate and fasten the reestablishment of the normal skin During a ten year observation period it was found that scar formation after thoracic surgery is influenced by various factors : metabolism , operative technique and factors of a general nature . On the basis of these findings , a study was carried out to investigate the effect of the scar-specific Contractubex gel ( Merz+Co . , D-Frankfurt/Main ) , containing 10 % onion extract , 50 U sodium heparin per g of gel and 1 % allantoin , in the treatment of children who underwent thoracic surgery and to evaluate its effect on scar development . Before and during the six-month treatment period , both macromorphology and scar colour were assessed ; furthermore , a global evaluation of the therapeutic result was made . Additionally , the scars were characterized after a six-month treatment-free follow-up period . The results of 38 Contractubex-treated and 27 untreated patients were compared . In the treated scars , the global evaluation of the therapeutic result was better than in the untreated scars . In the Contractubex group , the rating was " good " and " very good " in 84 % of cases , as compared to 59 % of the untreated cases . In the treated group , the increase in scar size was markedly lower than in the untreated patients . The treated scars showed a tendency towards quicker paling than the untreated scars . In the treated group , the conversion of primary physiological scars to unphysiological scars ( hypertrophic or keloidal scars ) was less frequent than in the untreated group . The tolerability of the product was very good in 37 of the 38 treated patients , and good in one patient . All scar-specific effects of Contractubex continued to persist after the end of treatment BACKGROUND Onion extract gel ( OE ) and 0.5 % hydrocortisone , silicone and vitamin E lotion ( HSE ) are two over-the-counter preparations used to enhance the cosmesis of keloids and hypertrophic scars . OBJECTIVE To determine the tolerability and efficacy of OE versus HSE versus placebo in subjects with keloids and hypertrophic scars . METHODS Thirty subjects ( > or = 18 years ) with keloids or hypertrophic scars were r and omly assigned to one of three study preparations for 16 weeks . Scar volume was measured at baseline and weeks 4 , 8 , 12 and 16 . Subjects and blinded investigators assessed scar parameters ( in duration , erythema , pigmentation alteration , pain , itching , tenderness and cosmetic appearance ) and patient satisfaction at each visit using a visual analog scale ( VAS ) . Data analysis included : mean percentage change ( MPC ) for subjects completing the study ( n = 15 ) ; the mixed model test to determine differences between the groups over time ; and the Kruskal-Wallis test for the analysis of differences in subjects ' satisfaction within the three groups over 16 weeks for subjects who completed at least one follow-up visit ( n = 21 ) . RESULTS All three preparations were well tolerated with the exception of a mild acneiform-like eruption in one OE patient . Significant improvements were obtained with OE in volume , length , width and in duration and with  HSE in volume , length , in duration , erythema and pigmentation alteration . There was a trend showing that a higher percentage of subjects were satisfied with OE than with HSE or placebo . The Mix Model Analysis ( MMA ) showed significant improvements with OE over placebo in investigator cosmetic assessment , lesion in duration , pigmentation and tenderness and with  HSE  over placebo in investigator cosmetic assessment , lesion in duration , pigmentation and erythema . Improvements in erythema and pigmentation were significantly greater in HSE than in OE . CONCLUSION Both OE and HSE were more effective than placebo in the management of hypertrophic scars and keloids BACKGROUND Cutaneous scars result ing from surgical procedures can be erythematous , hypertrophic , pruritic , painful , or cosmetically unacceptable . An onion extract-based topical gel ( Mederma , Merz Pharmaceuticals ) has been marketed as a product to improve scar appearance and texture . However , few data are available to substantiate these cl aims . OBJECTIVE To compare the efficacy between the onion extract gel and a petrolatum-based emollient ( Aquaphor , Beiersdorf , Inc. ) in improving the appearance and symptoms of new surgical scars .  METHODS Twenty-four patients with new surgical wounds at least 4 cm in length were enrolled in the study . Using a r and omized , double-blinded , split-scar study design , each scar was divided into two equal portions , and each half was assigned treatment with either onion extract gel or petrolatum ointment at the time of suture removal . Each product was applied three times daily for 8 weeks , and patients were evaluated at 2 , 8 , and 12 weeks following initiation of treatment . A follow-up phone interview was conducted at least 11 months postoperatively . RESULTS Scar halves were evaluated by blinded investigators for overall cosmetic appearance , erythema , and hypertrophy . Patients also independently rated side-specific erythema , pruritus , burning , and pain . Using the paired t-test and the Wilcoxon sign-rank test , we found no statistically significant difference ( p < .1 ) between the two treatment groups in any of the outcome variables studied . CONCLUSION Petrolatum-based topical agents constitute st and ard therapy in the management of postoperative wounds . In this side-by-side , r and omized , double-blinded , split-scar study , the onion extract gel did not improve scar cosmesis or symptomatology when compared with a petrolatum-based ointment Background We conducted an experimental study to compare the effect of massage using topical agents ( Kelo-cote or Contractubex ) on scar formation by massaging the healed burn wound on the dorsal area of Sprague-Dawley ( SD ) rats . Methods Four areas of second degree contact burn were made on the dorsal area of each of 15 SD rats , using a soldering iron 15 mm in diameter . After gross epithelialization in the defect , 15 SD rats were r and omly divided into four groups : the Kelo-cote group , Contractubex group , Vaseline group , and control group . Rats in three of the groups ( all but the Control group ) were massaged twice per day for 5 minutes each day , while those in the Control group were left unattended . For histologic analysis , we performed a biopsy and evaluated the thickness of scar tissue . Results In the Kelo-cote and Contractubex groups , scar tissue thicknesses showed a significant decrease , compared with the Vaseline and control groups . However , no significant differences were observed between the Kelo-cote and Contractubex groups . In the Vaseline group , scar tissue thicknesses showed a significant decrease , compared with the control groups . Conclusions The findings of this study suggest that massage using a topical agent is helpful in the prevention of scar formation and that massage only with lubricant ( no use of a topical agent ) also has a considerable effect , although not as much as the use of a topical agent . Thus , we recommend massage with a topical agent on the post-burn scar as an effective method for decreasing the scar thickness OBJECTIVE : After burn injuries , scarred skin lacks elasticity , especially in hypertrophic scars . Topical treatment with tretinoin can improve the appearance and quality of the skin ( i.e. , texture , distensibility , color , and hydration ) . The objective of this prospect i ve study was to examine the effects of treatment with 0.05 % tretinoin for one year on the biomechanical behavior and histological changes undergone by facial skin with post-burn scarring . Setting : Tertiary , Institutional . METHOD : Fifteen female patients who had suffered partial thickness burns with more than two years of evolution were selected .  Skin biopsies were obtained initially and after one year of treatment . The resistance and elastance of these skin biopsies were measured using a mechanical oscillation analysis system . The density of collagen fibers , elastic fibers , and versican were determined using immunohistochemical analysis . RESULTS : Tretinoin treatment significantly lowered skin resistance and elastance , which is a result that indicates higher distensibility of the skin . However , tretinoin treatment did not significantly affect the density of collagen fibers , elastic fibers , or versican . CONCLUSION : Topical tretinoin treatment alters the mechanical behavior of post-burn scarred skin by improving its distensibility and thus leads to improved quality of life for patients OBJECTIVES To investigate the safety and efficacy of Contractubex administration to  hypertrophic scars  in routine out-patient practice and to compare it to corticosteroid treatment . PATIENTS AND METHODS This was a multicenter , retrospective cohort study , based on 38 r and omly selected practice s representatively distributed in Germany , including dermatologists and general practitioners . Data from 859 patients fulfilling the inclusion criteria were assessed and analyzed . Of these , 771 patients were eligible for the per protocol treatment with Contractubex  ( n=555 ) and corticosteroid ( n=216 ) . The safety and efficacy of local administration of Contractubex to hypertrophic scars was compared to corticosteroid treatment . RESULTS At the end of defined treatment periods ( minimum 28 days for local therapy with 1 intralesional corticosteroid application ) , normalization of the pre-treatment pathological parameters ( erythema , pruritus , consistency ) of hypertrophic scars was more frequent ( 42.5 % ) after Contractubex per protocol treatment as compared to corticosteroid per protocol treatment ( 22.2 % ) . After adjusting imbalances of baseline characterisics between the treatment groups by the propensity score , the odds ratio was 2.274 , demonstrating a significant superiority ( p<0.001 ) of Contractubex treatment as compared to corticosteroid treatment . The time to normalization of erythema , pruritus and consistency was significantly ( p=0.034 ) shorter with Contractubex treatment ( median 344 days ) than with corticosteroids ( median 507 days ) . No unexpected or severe adverse events occurred in the Contractubex-treated patients . Apart from moderate pruritus ( 10 % Contractubex vs. 1 % corticosteroids ) , adverse events were significantly ( p<0.001 ) more frequent in  corticosteroid-treated patients ( teleangiectasias 15 % vs. 7 % Contractubex ; cutaneous atrophy of scars 10 % vs. 2 % Contractubex ; cutaneous atrophy of scar surrounding skin tissue 11 % vs. 1 % Contractubex ) . CONCLUSION For the primary aim of this study ( assessment of normalization of erythema , pruritus , and consistency of hypertrophic scars ) and for time to normalization , local administration of Contractubex was significantly more effective than corticosteroid treatment . Concerning safety , Contractubex treatment was associated with significantly less adverse events ( e.g. teleangiectasias , cutaneous atrophy of scars and surrounding skin tissue ) than topical corticosteroid application To date , few studies have compared the effectiveness of topical silicone gels versus that of silicone gel sheets in preventing scars . In this prospect i ve study , we compared the efficacy and the convenience of use of the 2 products . We en 
    Output:
    
agent
Contractubex showed best results in the prevention of pathological scars .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Ointments ( e.g. , petrolatum ) are thought to be occlusive , thereby blocking transcutaneous water loss and trapping water under the skin 's surface . If this premise is correct , then petrolatum should delay barrier recovery after barrier perturbation , as shown previously in occluded murine skin . OBJECTIVE We reexamined the assumption that Vaseline Petroleum Jelly ( VPJ ) is occlusive , ascertaining both its site and mechanism of action . METHODS Barrier recovery was measured in VPJ-treated versus untreated sites after acetone-induced barrier disruption in human volunteers . Moreover , VPJ was localized within the stratum corneum ( SC ) with tracers and ruthenium tetroxide staining , which allowed visualization of the depth of VPJ penetration and its relation to intercellular membrane structures . RESULTS VPJ accelerated , rather than impeded , barrier recovery . Moreover , VPJ was present within the interstices at all levels of the SC , where it replaced intercellular bilayers . CONCLUSION VPJ neither forms nor acts like an epicutaneous impermeable membrane ; instead , it permeates throughout the SC interstices , allowing normal barrier recovery despite its occlusive properties PURPOSE To evaluate and characterize the wound healing process profile induced by allantoin incorporated in soft lotion oil/water emulsion using the planimetric and histological methods . METHODS Female Wistar rats ( n=60 ) were r and omly assigned to 3 experimental groups : ( C ) control group-without treatment ; ( E ) group treated with soft lotion O/W emulsion excipients ; ( EA ) group treated with soft lotion O/W emulsion containing allantoin 5 % . The emulsions either containing or not allantoin were topically administered for 14 days and the wound area was evaluated by planimetry and by qualitative and quantitative histological analysis of open wound model . RESULTS The data which were obtained and analyzed innovate by demonstrating , qualitatively and quantitatively , by histological analysis , the profile of healing process induced by allantoin . The results suggest that the wound healing mechanism induced by allantoin occurs via the regulation of inflammatory response and stimulus to fibroblastic proliferation and extracellular matrix synthesis . CONCLUSION This work show , for the first time , the histological wound healing profile induced by allantoin in rats and demonstrated that it is able to ameliorate and fasten the reestablishment of the normal skin During a ten year observation period it was found that scar formation after thoracic surgery is influenced by various factors : metabolism , operative technique and factors of a general nature . On the basis of these findings , a study was carried out to investigate the effect of the scar-specific Contractubex gel ( Merz+Co . , D-Frankfurt/Main ) , containing 10 % onion extract , 50 U sodium heparin per g of gel and 1 % allantoin , in the treatment of children who underwent thoracic surgery and to evaluate its effect on scar development . Before and during the six-month treatment period , both macromorphology and scar colour were assessed ; furthermore , a global evaluation of the therapeutic result was made . Additionally , the scars were characterized after a six-month treatment-free follow-up period . The results of 38 Contractubex-treated and 27 untreated patients were compared . In the treated scars , the global evaluation of the therapeutic result was better than in the untreated scars . In the Contractubex group , the rating was " good " and " very good " in 84 % of cases , as compared to 59 % of the untreated cases . In the treated group , the increase in scar size was markedly lower than in the untreated patients . The treated scars showed a tendency towards quicker paling than the untreated scars . In the treated group , the conversion of primary physiological scars to unphysiological scars ( hypertrophic or keloidal scars ) was less frequent than in the untreated group . The tolerability of the product was very good in 37 of the 38 treated patients , and good in one patient . All scar-specific effects of Contractubex continued to persist after the end of treatment BACKGROUND Onion extract gel ( OE ) and 0.5 % hydrocortisone , silicone and vitamin E lotion ( HSE ) are two over-the-counter preparations used to enhance the cosmesis of keloids and hypertrophic scars . OBJECTIVE To determine the tolerability and efficacy of OE versus HSE versus placebo in subjects with keloids and hypertrophic scars . METHODS Thirty subjects ( > or = 18 years ) with keloids or hypertrophic scars were r and omly assigned to one of three study preparations for 16 weeks . Scar volume was measured at baseline and weeks 4 , 8 , 12 and 16 . Subjects and blinded investigators assessed scar parameters ( in duration , erythema , pigmentation alteration , pain , itching , tenderness and cosmetic appearance ) and patient satisfaction at each visit using a visual analog scale ( VAS ) . Data analysis included : mean percentage change ( MPC ) for subjects completing the study ( n = 15 ) ; the mixed model test to determine differences between the groups over time ; and the Kruskal-Wallis test for the analysis of differences in subjects ' satisfaction within the three groups over 16 weeks for subjects who completed at least one follow-up visit ( n = 21 ) . RESULTS All three preparations were well tolerated with the exception of a mild acneiform-like eruption in one OE patient . Significant improvements were obtained with OE in volume , length , width and in duration and with  HSE in volume , length , in duration , erythema and pigmentation alteration . There was a trend showing that a higher percentage of subjects were satisfied with OE than with HSE or placebo . The Mix Model Analysis ( MMA ) showed significant improvements with OE over placebo in investigator cosmetic assessment , lesion in duration , pigmentation and tenderness and with  HSE  over placebo in investigator cosmetic assessment , lesion in duration , pigmentation and erythema . Improvements in erythema and pigmentation were significantly greater in HSE than in OE . CONCLUSION Both OE and HSE were more effective than placebo in the management of hypertrophic scars and keloids BACKGROUND Cutaneous scars result ing from surgical procedures can be erythematous , hypertrophic , pruritic , painful , or cosmetically unacceptable . An onion extract-based topical gel ( Mederma , Merz Pharmaceuticals ) has been marketed as a product to improve scar appearance and texture . However , few data are available to substantiate these cl aims . OBJECTIVE To compare the efficacy between the onion extract gel and a petrolatum-based emollient ( Aquaphor , Beiersdorf , Inc. ) in improving the appearance and symptoms of new surgical scars .  METHODS Twenty-four patients with new surgical wounds at least 4 cm in length were enrolled in the study . Using a r and omized , double-blinded , split-scar study design , each scar was divided into two equal portions , and each half was assigned treatment with either onion extract gel or petrolatum ointment at the time of suture removal . Each product was applied three times daily for 8 weeks , and patients were evaluated at 2 , 8 , and 12 weeks following initiation of treatment . A follow-up phone interview was conducted at least 11 months postoperatively . RESULTS Scar halves were evaluated by blinded investigators for overall cosmetic appearance , erythema , and hypertrophy . Patients also independently rated side-specific erythema , pruritus , burning , and pain . Using the paired t-test and the Wilcoxon sign-rank test , we found no statistically significant difference ( p < .1 ) between the two treatment groups in any of the outcome variables studied . CONCLUSION Petrolatum-based topical agents constitute st and ard therapy in the management of postoperative wounds . In this side-by-side , r and omized , double-blinded , split-scar study , the onion extract gel did not improve scar cosmesis or symptomatology when compared with a petrolatum-based ointment Background We conducted an experimental study to compare the effect of massage using topical agents ( Kelo-cote or Contractubex ) on scar formation by massaging the healed burn wound on the dorsal area of Sprague-Dawley ( SD ) rats . Methods Four areas of second degree contact burn were made on the dorsal area of each of 15 SD rats , using a soldering iron 15 mm in diameter . After gross epithelialization in the defect , 15 SD rats were r and omly divided into four groups : the Kelo-cote group , Contractubex group , Vaseline group , and control group . Rats in three of the groups ( all but the Control group ) were massaged twice per day for 5 minutes each day , while those in the Control group were left unattended . For histologic analysis , we performed a biopsy and evaluated the thickness of scar tissue . Results In the Kelo-cote and Contractubex groups , scar tissue thicknesses showed a significant decrease , compared with the Vaseline and control groups . However , no significant differences were observed between the Kelo-cote and Contractubex groups . In the Vaseline group , scar tissue thicknesses showed a significant decrease , compared with the control groups . Conclusions The findings of this study suggest that massage using a topical agent is helpful in the prevention of scar formation and that massage only with lubricant ( no use of a topical agent ) also has a considerable effect , although not as much as the use of a topical agent . Thus , we recommend massage with a topical agent on the post-burn scar as an effective method for decreasing the scar thickness OBJECTIVE : After burn injuries , scarred skin lacks elasticity , especially in hypertrophic scars . Topical treatment with tretinoin can improve the appearance and quality of the skin ( i.e. , texture , distensibility , color , and hydration ) . The objective of this prospect i ve study was to examine the effects of treatment with 0.05 % tretinoin for one year on the biomechanical behavior and histological changes undergone by facial skin with post-burn scarring . Setting : Tertiary , Institutional . METHOD : Fifteen female patients who had suffered partial thickness burns with more than two years of evolution were selected .  Skin biopsies were obtained initially and after one year of treatment . The resistance and elastance of these skin biopsies were measured using a mechanical oscillation analysis system . The density of collagen fibers , elastic fibers , and versican were determined using immunohistochemical analysis . RESULTS : Tretinoin treatment significantly lowered skin resistance and elastance , which is a result that indicates higher distensibility of the skin . However , tretinoin treatment did not significantly affect the density of collagen fibers , elastic fibers , or versican . CONCLUSION : Topical tretinoin treatment alters the mechanical behavior of post-burn scarred skin by improving its distensibility and thus leads to improved quality of life for patients OBJECTIVES To investigate the safety and efficacy of Contractubex administration to  hypertrophic scars  in routine out-patient practice and to compare it to corticosteroid treatment . PATIENTS AND METHODS This was a multicenter , retrospective cohort study , based on 38 r and omly selected practice s representatively distributed in Germany , including dermatologists and general practitioners . Data from 859 patients fulfilling the inclusion criteria were assessed and analyzed . Of these , 771 patients were eligible for the per protocol treatment with Contractubex  ( n=555 ) and corticosteroid ( n=216 ) . The safety and efficacy of local administration of Contractubex to hypertrophic scars was compared to corticosteroid treatment . RESULTS At the end of defined treatment periods ( minimum 28 days for local therapy with 1 intralesional corticosteroid application ) , normalization of the pre-treatment pathological parameters ( erythema , pruritus , consistency ) of hypertrophic scars was more frequent ( 42.5 % ) after Contractubex per protocol treatment as compared to corticosteroid per protocol treatment ( 22.2 % ) . After adjusting imbalances of baseline characterisics between the treatment groups by the propensity score , the odds ratio was 2.274 , demonstrating a significant superiority ( p<0.001 ) of Contractubex treatment as compared to corticosteroid treatment . The time to normalization of erythema , pruritus and consistency was significantly ( p=0.034 ) shorter with Contractubex treatment ( median 344 days ) than with corticosteroids ( median 507 days ) . No unexpected or severe adverse events occurred in the Contractubex-treated patients . Apart from moderate pruritus ( 10 % Contractubex vs. 1 % corticosteroids ) , adverse events were significantly ( p<0.001 ) more frequent in  corticosteroid-treated patients ( teleangiectasias 15 % vs. 7 % Contractubex ; cutaneous atrophy of scars 10 % vs. 2 % Contractubex ; cutaneous atrophy of scar surrounding skin tissue 11 % vs. 1 % Contractubex ) . CONCLUSION For the primary aim of this study ( assessment of normalization of erythema , pruritus , and consistency of hypertrophic scars ) and for time to normalization , local administration of Contractubex was significantly more effective than corticosteroid treatment . Concerning safety , Contractubex treatment was associated with significantly less adverse events ( e.g. teleangiectasias , cutaneous atrophy of scars and surrounding skin tissue ) than topical corticosteroid application To date , few studies have compared the effectiveness of topical silicone gels versus that of silicone gel sheets in preventing scars . In this prospect i ve study , we compared the efficacy and the convenience of use of the 2 products . We en 
    Output:
    