Danielle M DeBruler1, Molly E Baumann2, Jacob C Zbinden2, Britani N Blackstone1, John Kevin Bailey3, Dorothy M Supp4,5,6, Heather M Powell1,2,4. 1. Department of Materials Science and Engineering, The Ohio State University, Columbus, Ohio, USA. 2. Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA. 3. Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. 4. Research Department, Shriners Hospitals for Children-Cincinnati, Cincinnati, Ohio, USA. 5. Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. 6. Center for Stem Cell & Organoid Medicine (CuSTOM), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Abstract
Objective: Despite the development of a number of treatment modalities, scarring remains common postburn injury. To reduce burn scarring, pressure garment therapy has been widely utilized but is complicated by low patient adherence. To improve adherence, reduced hours of daily garment wear has been proposed. Approach: To examine the efficacy of pressure garment therapy at reduced durations of daily wear, a porcine burn-excise-autograft model was utilized. Grafted burns were treated with pressure garments (20 mmHg) for 8, 16, or 24 h of daily wear with untreated burns serving as controls. Scar area, thickness, biomechanical properties, and tissue structure were assessed over time. Results: All treatment groups reduced scar thickness and contraction versus controls and improved scar pliability and elasticity. Pressure garments worn 24 h per day significantly reduced contraction versus the 8- and 16-h groups and prevented alignment of collagen within the dermis. Innovation: Though pressure garment therapy is prescribed for use 23 h per day, the need for almost continuous use has not been previously examined. Adjustable, low-fatigue pressure garments were developed for this porcine study to examine the role of daily duration of wear without confounding factors such as garment fatigue and patient adherence. Conclusion: For maximum efficacy, pressure garments should be worn 23 to 24 h per day; however, garments worn as little as 8 h per day significantly improve scar outcomes versus no treatment.
Objective: Despite the development of a number of treatment modalities, scarring remains common postburn injury. To reduce burn scarring, pressure garment therapy has been widely utilized but is complicated by low patient adherence. To improve adherence, reduced hours of daily garment wear has been proposed. Approach: To examine the efficacy of pressure garment therapy at reduced durations of daily wear, a porcine burn-excise-autograft model was utilized. Grafted burns were treated with pressure garments (20 mmHg) for 8, 16, or 24 h of daily wear with untreated burns serving as controls. Scar area, thickness, biomechanical properties, and tissue structure were assessed over time. Results: All treatment groups reduced scar thickness and contraction versus controls and improved scar pliability and elasticity. Pressure garments worn 24 h per day significantly reduced contraction versus the 8- and 16-h groups and prevented alignment of collagen within the dermis. Innovation: Though pressure garment therapy is prescribed for use 23 h per day, the need for almost continuous use has not been previously examined. Adjustable, low-fatigue pressure garments were developed for this porcine study to examine the role of daily duration of wear without confounding factors such as garment fatigue and patient adherence. Conclusion: For maximum efficacy, pressure garments should be worn 23 to 24 h per day; however, garments worn as little as 8 h per day significantly improve scar outcomes versus no treatment.
Authors: Danielle M DeBruler; Molly E Baumann; Britani N Blackstone; Jacob C Zbinden; Kevin L McFarland; J Kevin Bailey; Dorothy M Supp; Heather M Powell Journal: Plast Reconstr Surg Date: 2019-02 Impact factor: 4.730
Authors: Megan M Malara; Jayne Y Kim; J Alexander Clark; Britani N Blackstone; Mark A Ruegsegger; J Kevin Bailey; Dorothy M Supp; Heather M Powell Journal: J Burn Care Res Date: 2018-06-13 Impact factor: 1.845
Authors: Shawn Tejiram; Jenny Zhang; Taryn E Travis; Bonnie C Carney; Abdulnaser Alkhalil; Lauren T Moffatt; Laura S Johnson; Jeffrey W Shupp Journal: J Surg Res Date: 2015-11-05 Impact factor: 2.192
Authors: Alexander Anzarut; Jarret Olson; Prabhjyot Singh; Brian H Rowe; Edward E Tredget Journal: J Plast Reconstr Aesthet Surg Date: 2008-01-14 Impact factor: 2.740