K Number
K974354
Device Name
MEPIFORM ADHERENT SILICONE DRESSING FOR SCAR CARE
Manufacturer
Date Cleared
1998-03-05

(106 days)

Product Code
Regulation Number
878.4025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Mepiform Adherent Silicone Dressing is intended for the management of both old and new hypertrophic and keloid scars. It can also be used as a prophylactic therapy on closed wounds which may prevent hypertrophic or keloid scarring.
Device Description
The Mepiform Adherent Silicone Dressing for Scar Care consists of a silicone coated nonwoven bonded to an adhesive thermoplastic polyurethene film. The silicone dressing is protected by a low density polyethylene release film. The Mepiform dressing is individually sealed in a medical grade paper pouches and packaged in cartons of five (5) pouches each. The Mepiform dressings are available in two sizes: 5 cm x 7.5 cm (2" x 3") and 10 cm x 18 cm (4" x 7").
More Information

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Not Found

No
The device description and intended use describe a physical silicone dressing for scar management, with no mention of software, algorithms, or AI/ML capabilities.

Yes
The intended use explicitly states management of scars and prophylactic therapy to prevent scarring, both of which are therapeutic actions.

No
The Mepiform Adherent Silicone Dressing is intended for the management and prevention of scars, making it a therapeutic device rather than a diagnostic one. It does not identify or detect diseases or conditions.

No

The device description clearly describes a physical dressing made of silicone, nonwoven material, and adhesive film, indicating it is a hardware medical device, not software.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for the management and prevention of scars on the skin. This is a therapeutic and prophylactic use applied directly to the body, not a diagnostic test performed on samples taken from the body.
  • Device Description: The device is a dressing applied to the skin. It does not involve any reagents, instruments, or procedures for analyzing biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in biological samples
    • Providing information for diagnosis, monitoring, or screening of diseases or conditions.

Therefore, the Mepiform Adherent Silicone Dressing is a medical device, but it falls under a different category than In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

Mepiform Adherent Silicone Dressing is intended for the management of both old and new hypertrophic and keloid scars. It can also be used as a prophylactic therapy on closed wounds which may prevent hypertrophic or keloid scarring.

Product codes

MDA

Device Description

The Mepiform Adherent Silicone Dressing for Scar Care consists of a silicone coated nonwoven bonded to an adhesive thermoplastic polyurethene film. The silicone dressing is protected by a low density polyethylene release film.

The Mepiform dressing is individually sealed in a medical grade paper pouches and packaged in cartons of five (5) pouches each. The Mepiform dressings are available in two sizes: 5 cm x 7.5 cm (2" x 3") and 10 cm x 18 cm (4" x 7").

Mepiform Adherent Silicone Dressing for Scar Care have been shown in laboratory tests to be nontoxic, nonirritant, and nonsensitizing.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

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Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

Not Found

Key Metrics

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Predicate Device(s)

Smith & Nephew Cica-Care™ Adhesive Gel Sheet

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4025 Silicone sheeting.

(a)
Identification. Silicone sheeting is intended for use in the management of closed hyperproliferative (hypertrophic and keloid) scars.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 878.9.

0

K974354

MAR - 5 1998

510(k) SUMMARY

Proprietary Name:Mepiform
Common Name:Adherent Silicone Dressing for Scar Care
Classification:Unclassified
Submitter:SCA Mölnlycke
500 Baldwin Tower
Eddystone, PA 19022
Contact Person:Miguel A. Negron
Tel. 610-499-3383
Fax. 610-499-3396
Predicate Device:Smith & Nephew Cica-Care™ Adhesive Gel Sheet

Description:

The Mepiform Adherent Silicone Dressing for Scar Care consists of a silicone coated nonwoven bonded to an adhesive thermoplastic polyurethene film. The silicone dressing is protected by a low density polyethylene release film.

The Mepiform dressing is individually sealed in a medical grade paper pouches and packaged in cartons of five (5) pouches each. The Mepiform dressings are available in two sizes: 5 cm x 7.5 cm (2" x 3") and 10 cm x 18 cm (4" x 7").

Mepiform Adherent Silicone Dressing for Scar Care is intended for the management of both old and new hypertrophic and keloid scars. It can also be used as a prophylactic therapy on close wounds which may prevent hypertrophic or keloid scarring.

Mepiform Adherent Silicone Dressing for Scar Care have been shown in laboratory tests to be nontoxic, nonirritant, and nonsensitizing.

1

Image /page/1/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes coiled around it. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the caduceus symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR - 5 1998

Mr. Miguel A. Negron Manager, Requlatory Affairs & Quality Assurance North America SCA Molnlycke 500 Baldwin Tower Eddystone, Pennsylvania 19022

Re: K974354 Mepiform Adherent Silicone Dressing for Trade Name: Scar Care Regulatory Class: Unclassified Product Code: MDA February 18, 1998 Dated: February 19, 1998 Received:

Dear Mr. Negron:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual reqistration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A ..... substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

2

Page 2 - Mr. Negron

This letter will allow you to begin marketing your device as described in your 510 (k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4595. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Celia M. Witten, Ph.D., M

Celia M. Witten, Ph.D., M.D. Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

K974354

PREMARKET NOTIFICATION

INDICATIONS FOR USE STATEMENT

510(k) Number: K974354 SCA Mölnlycke

Device Name: Mepiform Adherent Silicone Dressing for Scar Care

Indications for Use:

Mepiform Adherent Silicone Dressing is intended for the management of both old and new hypertrophic and keloid scars. It can also be used as a prophylactic therapy on closed wounds which may prevent hypertrophic or keloid scarring.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109) OR

Over-The-Counter Use

. coley

(Division Sign-Off of General Restorative Devices 510(k) Num

לייני

SCA Mölnlycke