Efficacy Of Pressure Garment Therapy At Reduced Lengths Of Daily Wear
Danielle M. DeBruler1, Jacob C. Zbinden1, Molly E. Baumann1, Britani N. Blackstone1, John K. Bailey1, Dorothy M. Supp2, Heather Powell1.
1The Ohio State University, Columbus, OH, USA, 2Shriners Hospitals for Children, Cincinnati, OH, USA.
BACKGROUND: Patient compliance is a challenge associated with pressure garment therapy. We hypothesize that if patients were able to wear the garments for less time per day, the discomforts associated with garment use would be reduced and patient compliance may improve. METHODS: To examine the effect of duration of daily wear on outcomes, full-thickness burns (1 x 1 in) were created on red Duroc pigs (8 burns/pig), excised and autografted with split-thickness skin. Adjustable pressure garments were applied 1 week after grafting and maintained at 20 + 2 mm Hg. Garments were worn for 8, 16, or 24 hours a day for 15 weeks; control scars did not receive any pressure treatment (n=16/group). RESULTS: At 15 weeks, scars in the 24 hour/day group were approximately 50% less contracted than controls and 30% less contracted than the 8 and 16 hour/day groups (p < 0.05). All treatment conditions significantly reduced scar thickness vs. controls (p < 0.05). Scar stiffness and pliability were significantly improved over controls with just 8 hours/day of wear; however, applying pressure 24 hours a day enhanced these effects and also improved skin elasticity. CONCLUSIONS: Pressure garments worn for at least 8 hours/day are effective at reducing contraction and scar thickness and improving pliability versus controls; however, the greatest benefits in scar properties were observed with continuous use (24 hours/day).
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