Interim Pressure Garment Therapy: An investigation into the use of low level pressure therapy for burns donor site support and scar reduction

Ms Michelle Donovan1, Dr Zephanie Tyack2, Dr  Claire Simpson3, Professor Michael Muller4, A/Professor Jenny Paratz5

1Occupational Therapy Royal Brisbane And Women’s Hospital, Herston, Brisbane , Australia, 2Burns, Trauma & Critical Care Research Centre, School of Medicine, University of Queensland,  Herston, Brisbane, Australia, 3Centre for Children’s Burns and Trauma Research, UQ-Child Health Research Centre Level 6, CCHR   Building, The University of Queensland, St Lucia, Brisbane, Australia, 4Professor Stuart Pegg Adult Burns Centre, Royal Brisbane & Women’s Hospital, Level 4, Dr James Mayne Building, Herston, Brisbane, Australia, 5School of Allied Health Sciences, Griffith University, Gold Coast Campus,, Southport, Australia


Abstract:

Background: Pressure garment therapy (PGT) is commonly used in the treatment of burns scars and has been the focus of many studies. However, there has been little investigation of PGT to treat burn donor sites. Two studies were undertaken to determine the effectiveness of PGT for early donor site support and scar reduction.

Method: A cross sectional single centre design of 47 healthy volunteers was undertaken to firstly establish size and pressure ranges of an Interim PGT (IPGT) for donor sites. The pressure at the skin/garment interface was determined using the thin sensor pad of the Pico Press®.  A subsequent pilot study (n=8) was conducted to test the effectiveness of IPGT for donor site scar reduction using a single centre, single (assessor) blinded, randomised, controlled trial of burn patients who had thigh donor sites following skin grafting.  The IPGT was administered post-operatively, and worn for 23 hours per day for a period of 12 weeks. Donor scar thickness was measured using the Dermascan C® high frequency ultrasound.  Descriptive statistics and multiple regression were used to analyse the findings.

Results: The mid-thigh measurement was a significant predictor of the IPGT sizes small, medium and large (p < 0.001, p = 0.64 and p = 0.13) and provided a pressure range of 3 to 7 mmHg at the donor site thigh location. The results of the IPGT pilot study indicated a trend towards a decrease in donor site scar thickness over time for the IPGT group (p = 0.07), compared to the control group. Results also indicated that there were a number of parameters such as pain and itch severity that appeared to reduce over time, however no significant differences (p = 0.48 and p = 0.29 respectively) between the groups over time were found possibly due to such low participant numbers.

Conclusion: Preliminary data demonstrates IPGTs may be a feasible, safe and practical early scar reduction technique for donor sites. Directions for further research will be described.


Biography:

Michelle Donovan is a senior Occupational Therapist at the Royal Brisbane and Women’s Hospital with a special interest in burn scar management. She graduated from the University of Queensland with a Bachelor of Occupational Therapy and has recently completed a Master of Philosophy in burn donor site management. Michelle has 14 years’ experience across vascular, plastics and burn care rehabilitation. She provides professional guidance to occupational therapists, students and patients in metropolitan, rural and remote areas of Australia, and aboard in Nepal. Michelle holds a clinical academic title at the University of Queensland (School of Health and Rehabilitation Sciences) as an associate lecturer and is an active member of the Australia and New Zealand Burn Association. Michelle is a published novice researcher with research funding totaling $50 000.