A six-point programme for the prevention and pressure therapy of hypertrophic scarring started in 1975 at Odstock Hospital. The work reported here includes a pressure calibration of batches of the material chosen for pressure bandaging; a pressure study of the bandages on volunteers' limbs; and the formation of a pressure therapy clinic. The clinic results were similar to those reported by Thomson (1974) and were considered sufficiently favourable to justify continuing the clinic and instituting a policy of close review and early therapy for all burns patients. The programme proved the accuracy of the pressure sensor and attempted to develop an objective method of recording progress. Arguments for pressure versus occlusion as the therapeutic agent are discussed and supported by a case report. It is suggested that a controlled trial of pressure therapy should be carried out.
The art of fitting the environment to the patient is sadly lacking. There are at least 24 000 patients in Great Britain suffering from pressure sores. The art will not improve until relevant parameters of tissue viability are measured routinely wherever patients are cared for. Disorders of temperature and blood pressure were not understood until standard measurements were widely taken. What are the relevant parameters for disorders of tissue viability? The authors single out pressure and movement, and note that pressure recorded with time will also monitor movement. They offer their flanged 28 mm electro-pneumatic pressure sensor as a possible standard instrument for most clinical purposes whether research or routine. The discussion covers the theoretical objections to interface pressure measurement, analyses the sources of error in their electro-pneumatic technique and compares its accuracy to that of other transducers.
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