Early cessation of pressure garment therapy results in scar contraction and thickening.

Autor: DeBruler DM; Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States of America., Zbinden JC; Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States of America., Baumann ME; Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States of America., Blackstone BN; Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States of America., Malara MM; Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States of America., Bailey JK; Department of Surgery and Division of Critical Care, Trauma and Burns, The Ohio State University, Columbus, OH, United States of America.; Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States of America., Supp DM; Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States of America.; Department of Surgery, University of Cincinnati, Cincinnati, OH, United States of America., Powell HM; Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States of America.; Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States of America.; Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2018 Jun 13; Vol. 13 (6), pp. e0197558. Date of Electronic Publication: 2018 Jun 13 (Print Publication: 2018).
DOI: 10.1371/journal.pone.0197558
Abstrakt: Pressure garment therapy is often prescribed to improve scar properties following full-thickness burn injuries. Pressure garment therapy is generally recommended for long periods of time following injury (1-2 years), though it is plagued by extremely low patient compliance. The goal of this study was to examine the effects of early cessation of pressure garment therapy on scar properties. Full-thickness burn injuries were created along the dorsum of red Duroc pigs. The burn eschar was excised and wound sites autografted with split-thickness skin. Scars were treated with pressure garments within 1 week of injury and pressure was maintained for either 29 weeks (continuous pressure) or for 17 weeks followed by cessation of pressure for an additional 12 weeks (pressure released); scars receiving no treatment served as controls. Scars that underwent pressure garment therapy were significantly smoother and less contracted with decreased scar height compared to control scars at 17 weeks. These benefits were maintained in the continuous pressure group until week 29. In the pressure released group, grafts significantly contracted and became more raised, harder and rougher after the therapy was discontinued. Pressure cessation also resulted in large changes in collagen fiber orientation and increases in collagen fiber thickness. The results suggest that pressure garment therapy effectively improves scar properties following severe burn injury; however, early cessation of the therapy results in substantial loss of these improvements.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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