Pressure garment therapy is standard of care for prevention and treatment of hypertrophic scarring after burn injury. Nevertheless there is little objective data that confirms effectiveness. The purpose of this study was to determine the effectiveness of pressure garment therapy with objective data obtained with a randomized within-wound comparison. We enrolled consecutive patients with forearm injuries over a 12-year period. The subjects wore custom garments with normal and low compression randomized to either the proximal or distal zones. Hardness, color and thickness of wounds were objectively measured using appropriate devices; clinical appearance was measured by a panel masked to the identity of the pressure treated area. Wounds treated with normal compression were significantly softer, thinner, and had improved clinical appearance. There was no interaction of any effect with patient ethnicity. However, these findings were clinically evident only with moderate to severe scarring. We conclude that pressure garment therapy is effective, but that the clinical benefit is restricted to those patients with moderate or severe scarring.

Journal Article Does INTEGRA™ Shorten Time in Pressure Garments? Get access B. A. Costa, OTR, B. A. Costa, OTR 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar S. Honari, RN, S. Honari, RN 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar A. R Carlson, AAS, A. R Carlson, AAS 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar S. Wiechman, PhD, S. Wiechman, PhD 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar D. Y. Nakamura, OTR, D. Y. Nakamura, OTR 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar M. L. Moore, PT, M. L. Moore, PT 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar D. M. Heimbach, MD, FACS, D. M. Heimbach, MD, FACS 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar L. H. Engrav, MD, FACS, L. H. Engrav, MD, FACS 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar N. S. Gibran, MD, FACS N. S. Gibran, MD, FACS 1University of Washington, Seattle, WA Search for other works by this author on: Oxford Academic Google Scholar The Journal of Burn Care & Rehabilitation, Volume 24, Issue suppl_2, March-April 2003, Page S86, https://doi.org/10.1097/00004630-200303002-00088 Published: 01 March 2003

Although excision and grafting of burns has become common and standard, many surgeons have been reluctant to excise and graft face burns. In fact, we could find photographic results at 1 year after grafting of only eight patients in the English literature. We began excision and grafting of face burns in 1979 and presented our first 16 patients in 1986 in this journal. With encouragement from Janzekovic and Jackson, we continued and have now used essentially the same procedure for more than 20 years in approximately 100 patients and, from this large series, are able to present outcomes. From January of 1979 to May of 1999, we performed excision and grafting on 91 patients with deep face burns. Data were recorded and 35-mm photographs were obtained throughout the 20-year period. We reviewed that database and the slide files of these patients. We found 45 patients with complete photographic sets including 1-year follow-up. Since, in our opinion, there is no useful, objective measure of appearance, we decided to simply publish all 45 sets of complete photographs, permitting the reader to subjectively form an opinion of the outcome of this procedure. The results are all shown as "full" face burns and two "partial" face burns. We continue to believe that early excision and grafting is indicated for face burns that will not heal within 3 weeks and that the procedure yields results that permit the burn victims to return to society and minimizes the time off work or out of school.

Calculating impairment in burn patients is crucial to understanding outcome. However, it is rarely reported after burns, presumably because the process of calculating impairment ratings is complicated and tedious. Computerized systems have been developed that facilitate the process, but it has not been established in burn patients that these systems reduce the time required to calculate impairment. We evaluated the Dexter Evaluation and Therapy System by Cedaron Medical Inc (Davis, CA). A sample of 10 manually recorded ratings was compared with 10 performed on the Dexter. Mean time for the manual technique was 65 +/- 35 minutes versus 37 +/- 13 minutes for the Dexter (P < .05, Mann-Whitney). The time taken to perform impairment ratings in burn survivors is significantly reduced by the use of the Dexter system. Time saving occurs primarily at three points: (1) electronic data entry directly from the measuring instruments, (2) compilation of data, and (3) rapid generation of reports.