Burn Scar Maturation with or without Pressure Garment Therapy (PGT)

Dr Zhe Li1,2, Frank Li1, Brooke Farrugia3, Young  Li4, Professor Peter Maitz1,2

1Burns Unit, Concord Hospital, Concord, Australia, 2University of Sydney Medical School, Sydney, Australia, 3Graduate School of Biomedical Engineering, UNSW, Sydney, Australia, 4Pathology, Concord Hospiotal, Concord, Australia

Delayed wound healing in severe burns leads to aberrant ECM deposition in dermal tissue and the development of hypertrophic scar (HS).

PGT is commonly used for HS management in the believe that the compression could restrict the blood flow to scar area, inhibit HS tissue growth by controlling collagen synthesis, causing apoptosis, limiting nutrient supplies.1,2,3 Mechanically PGT significantly hindered scar contraction, reduced skin hardness and increased skin strength.4 However, as HS has a natural trend to mature by itself given enough time, studies raised questions about the effect of PGT on scar maturation 5 suggesting the evidence of PGT effectiveness was anecdotal6 . A meta-analysis of randomized controlled trials indicated that PGT does not appear to alter global scar scores. 7

This study aims to define the progression characteristics of HS at histological, cellular and molecular levels. Biopsies were collected from HS areas with or without PGT compression through a time course post burns.  In addition to monitor the clinical features and the changes of ECM proteins in HS tissue, we also examined the changes of proteoglycans (PGs) and glycosaminoglycans (GAGs), the key skin molecules in normal skin, compressed and non-compressed HS samples. PGs and GAGs are critical for wound healing, skin remodelling and skin function. Data from this study would facilitate better understanding the development and maturation of HS in severe burns. More importantly, it could help define the clinical effectiveness of PGT in HS prevention and treatment, and understand how PGT regulates HS remodelling and maturation post burns.

Through years of medical and scientific trainings, Dr Zhe Li has developed expertise knowledge and skills in cell biology, skin tissue engineering and regenerative medicine; and cell/tissue therapy for severe burn wound healing.  Since 2003 he has been leading the clinical laboratory service to provide cultured skin autografts for severe burn care in all Burn Centrers under NSW Statewide Severe Burns Services.

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