Mr Dale Edwick1,2,3, Dr Dana Hince3, Mr Jeremy Rawlins1,5, Professor Fiona Wood1,2,4, A/Professor Dale Edgar1,2,3,4
1Fiona Stanley Hospital, Murdoch, Australia, 2Fiona Wood Foundation, Murdoch, Australia, 3The University of Notre Dame Australia, Fremantle, Australia, 4The University of Western Australia, Nedlands, Australia, 5Royal Perth Hospital, Perth, Australia
Introduction: Compression, a common treatment of choice for the management of oedema, is one intervention which is applied with little objective understanding of the optimal parameters of application or efficacy in a patient with an acute burn wound. The aim of this study was to determine the effectiveness of different methods of compression for the management of oedema following hand burn injury. This is the first known single centre RCT comparing the application of cohesive bandage (Coban) to an off the shelf compression glove as interventions for managing acute hand burn oedema.
Methods: A randomised control study of patients presenting with hand burn injury. Compression was randomised to one of three application methods: 1) spiral application of Coban to fingers, figure-of-eight to hand and wrist; 2) pinched Coban to fingers, spiral to hand and wrist; or 3) an off-the-shelf compression glove (control condition). Repeated volume measures of the hand were recorded using bioimpedance spectroscopy. The results were analysed using multi-level mixed effects regressions.
Results: One hundred ambulatory patients (68 males) were recruited to this study. The mean TBSA injured was 0.51±0.96%. Patients were recruited 2.81±1.69 days postinjury. Compression was applied for 2.11±0.40 days. Both methods of applying Coban were more effective at reducing oedema than the off-the-shelf glove – spiral application χ2 (p=0.007); cylinder application χ2 (p=0.01). There was no evidence of difference between methods of applying Coban for managing oedema.
Conclusion: This study confirms that Coban individualised gloves are superior to generic compression gloves for reducing acute hand burn oedema.
Dale is a Senior Physiotherapist in the State Adult Burns Unit at Fiona Stanley Hospital in Western Australia. He is finalising his PhD studies through the School of Physiotherapy at The University of Notre Dame Australia. His research interests are the use of technology to measure wound healing and oedema, and the proactive management of oedema following hand and minor burn injury. When not at work, Dale is at home with his OT wife and 2 beautiful daughters, and likes to keep fit by running and bouldering.