Mrs Kate Sands1, Mrs Tamsin Mahoney1, Dr. Megan Simons1,2
1Pegg Leditschke Children’s Burns Centre – Lady Cilento Children’s Hospital, Brisbane, Australia, 2Centre for Children’s Burns and Trauma Research – Centre for Children’s Health Research, Brisbane, Australia
Background:Pressure garments are routinely used for burns scar management, with higher pressures considered more effective. The use of padding inserts in pressure garments to increase localized pressure is practiced clinically, however there are currently no published guidelines. The aim of this study was to examine current practice and state of the evidence regarding the use of padding inserts in pressure garments.
Method:A Rapid Evidence Assessment (REA) was conducted. A number of databases were searched using inclusion criteria featuring scar outcomes on hypertrophic scarring from using padding inserts. Combined treatments involving silicone were excluded. Additionally, burns therapists across Australia and New Zealand were surveyed about their experience and understanding of padding inserts in pressure garments for scar management.
Results:There were 2087 studies sourced. Following screening, 35 full texts were reviewed. The appraisal highlighted a lack of translatable, quality evidence supporting or comparing inserts in pressure garments.
Of the 25 respondents, 96% used padding inserts (including foam, silicone, otoform, mineral oil sheets etc). The majority (84%) were not aware of evidence supporting the use for such treatment. Reasons for use, benefits, contraindications and prescription details were wide-ranging.
Conclusion:There is a lack of translatable, quality evidence regarding the use of padding inserts in pressure garments, along with significant variability in use, understanding and prescription amongst Australian and New Zealand burns therapists. These results indicate that further research about the efficacy and properties of padding inserts is needed. A reference guide featuring available insert materials for therapists will be discussed.
Kate is an Occupational Therapist at the Lady Cilento Children’s Hospital, currently working in the Pegg Leditschke Children’s Burns Centre.