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Pracasil -Compounding Scars away

Posted by Gerhard Fourie on

Written on the 6 March 2016 by The Compounding Team

Wound therapy and the treatment of scars have always been topical matters from a practical, as well as a cosmetic point of view. This article explores the effectiveness of Fatty acids, from pracaxi oil, in a topical silicone base, utilised for scar and wound therapy. The Pracasil supplied by Your Solution Compounding Pharmacy is similar to that used in the study, as prescribed by the physician and compounded to meet the specific requirements for the patient's treatment.

Sponsorship for a study was funded by the Professional Compounding Centres of America (PCCA), while medical writing assistance for the study was provided by Dr. Chantelle Rein-Smith and Robin Whitsell, of Whitsell Innovations, Inc. (Chapel Hill, USA).
The following were noted at the introduction of the study scope and presentation of the results:

  • The preparation of customised treatments for individual patients represents an important therapeutic goal in the fields of dermatology and wound healing.
  • Pracaxi oil, derived from the seeds of the Pentaclethra macroloba tree, indigenous to the Amazon, contains high amounts of oleic, linoleic, and behenic fatty acids which are integral to the formation and maintenance of cell membranes.
  • Seven patients, ranging in age from 5 months to 72 years, with a variety of wound types, applied a compounded anhydrous silicone base containing pracaxi oil; with or without additional active ingredients.
  • Satisfaction with the results was high, and the wounds or scars of all seven patients were considered "improved" or "much improved" by a dermatologist after application of the compounded base, containing pracaxi oil.
  • A compounded topical anhydrous silicone base containing pracaxi oil is a potentially useful option in the management of wound and scar therapy.

A summary (below) of the study is revealing.

INTRODUCTION
Wounding affects the integrity of the skin and can ultimately result in skin scarring. Current therapeutic goals of wound treatment focus on the reduction of scar formation and on severity. However, scar formation itself varies not only between individuals based on factors such as ethnicity, but also within an individual, based on the location of the wound. Therefore, the preparation of customized treatments for individual patients represents an important therapeutic goal in the fields of dermatology and wound healing. The objective of this study was to evaluate the usefulness of fatty acids found in pracaxi oil in a compounded topical anhydrous silicone base for wound and scar therapy.

METHODS
Initially, 21 patients with various surgical, traumatic, or burn wounds and scars were enrolled into this case series. Patients applied a compounded topical anhydrous silicone base containing pracaxi oil with or without additional active ingredients, including pentoxifylline, caffeine, tranilast, and mupirocin. Wound/scar photographs taken before and after application of the compounded pracaxi oil topical formulation, (with/without additional ingredients), were then reviewed and adjudicated by a blinded dermatology reviewer. Improvements in wound size, coloration, and overall appearance before and after treatment were determined. Patient satisfaction was assessed after application of the compounded topical formulation, using a self-report questionnaire distributed at the time of dispensing.

RESULTS
A total of seven patients were considered available for analysis and were included in the study. In all seven cases, patients reported improvement in scar and wound attributes, including scar and wound size, severity, colour, and pain associated with the scar or wound after application of the compounded medicine. On average, patients rated their satisfaction with treatment highly, with a mean score of 10 on a rating scale of 1-10. Retrospective review of wound/scar photographs demonstrated clinically relevant improvements in wound attributes as assessed by a dermatologist. Six of the seven wounds examined were considered "much improved" from the baseline.

CONCLUSIONS
Application of a compounded anhydrous silicone base containing pracaxi oil alone, or in combination with other active substances, led to considerable improvements in wound healing and scar attributes and is a potentially useful option in the treatment of surgical, traumatic, or burn wounds and scars.
-As an example the image above is a second degree facial burn on the face of a 5-month-old infant before, and then 8 days after application of compounded base containing pracaxi oil. (Watch the video here), or select the icon.

FINAL COMMENT-

An anecdotal and paraphrased comment from a registered nurse can perhaps best summarise a personal experience:
I want to start off by saying that I am a nurse and this is a legitimate review from a sceptical clinician. I found out about PracaSil from another nurse who works in the burn centre at my hospital in New York. There it is used to treat burn victims because of the high concentration of silicones this product contains, and as well as for pain management. I requested a script for PracaSil cream with pain medication compounded into it, which included Gabapentin 15%; the same formula used at the burn centre. I wanted this for post-op pain and scarring from a C-section with my second daughter. I had a C-section for the birth of my first child as well, and the pain afterwards was horrible. I had adverse side effects to the pain medications that I was given, and did not want to repeat that experience. In addition, I also was breast feeding and concerned about side effects on my baby. The cream arrived at my house, and I began using it immediately. I had minimal breakthrough pain and no side effects; unlike the previous time with pain pills, having tried Vicodin and OxyContin. The effects truly were remarkable. The scar virtually disappeared after 6 weeks. This included the scarring I had from my first C-section too! It is now 13 weeks post baby and there is no scar. My old scar is completely gone too, with the exception of two little skin staple hole marks.

Please contact Your Solution Compounding Pharmacy for more information about Pracasil, or visit us at 1/6 Pine Rivers Office Park, 205 Leitchs Rd. Brendale, QLD.

References
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