A histological study on the effect of pressure therapy on the activities of myofibroblasts and keratinocytes in hypertrophic scar tissues after burn

Li-Tsang, Cecilia W. P.; Feng, Beibei; Huang, Lin; Liu, Xusheng; Shu, Bin; Chan, Yvonne T.Y.; Cheung, Kwok-Kuen

doi:10.1016/j.burns.2014.11.017

Cited by 48 publications

(90 citation statements)

References 37 publications

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“…There are many methods for the treatment of the Hyperplasia scar, such as pressure therapy, intralesional corticosteroids, radiation therapy and topical medications [3]. Pressure therapy is one of the most effective methods to prevention and treatment of Hyperplasia scar and this method is easy to operate, having an exact curative effect, low price, and is noninvasive treatment [4,5].…”

Section: Introductionmentioning

confidence: 99%

Compression Sleeves Design Based on Laplace Laws

Zhao¹,

Li²,

Yu³

et al. 2017

JTEFT

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Compression sleeves are very important to the prevention and control of human limb hyperplasia scaring. The garment pressure is the key determinant of the curative effect, and one of the key factors which influence this value is the precision of Compression sleeves design. In order to study the design and performance of Compression sleeves via relatively simple but accurate methodologies, different deformation formulas of Laplace law were summarized and analyzed. Firstly, it was found that both of the deformation formulas of Laplace law proposed by Maklewska and Leung respectively were based on the principle that the arm radius was calculated by the arm circumference, furthermore, the arm radius, fabric tensile index and the preset clothing pressure were substituted into the Laplace law formula, and the sizes of the Compression sleeves could be calculated. Since the design methods proposed above were easier to implement in practical production, Compression sleeves were designed and manufactured based on the deformation formulas of Laplace law, and garment pressures were tested and compared with the preset pressures. Experimental results showed that garment pressures of the Compression sleeves which were designed based on the Maklewska Laplace law within the scope of the required pressure value, so this deformation could be used for designing the Compression sleeves accurately. However, the sizes of the Compression sleeves which were calculated based on the Leung Laplace law were too small to put on, so the formula of Leung Laplace law was not suitable for designing the Compression sleeves.

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Section: Introductionmentioning

confidence: 99%

Compression Sleeves Design Based on Laplace Laws

Zhao¹,

Li²,

Yu³

et al. 2017

JTEFT

View full text Add to dashboard Cite

show abstract

“…Although some experts have suggested applying pressure within a range of 15 mm Hg-25 mmHg [16,23,24,26,29,30,[38][39][40], many experts have recommended wearing silica gel film inside the pressure garments (only at locations with hard or convex scars), but this type of silicon film can only be worn for 8-12 hours per day [6,12,14,41,42] because such items can lengthen scarring duration and can be allergenic. However, they still have a favourable effect.…”

Section: Prominentmentioning

confidence: 99%

Fitted Pressure Garment of Assessment of Scar Thickness on Third-Degree Burns through Ultrasonic Measurement

Huang¹,

Lu²,

Liu³

2017

J Cytol Histol

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The aim of this study was to assess the thickness of the scars on the left arm of a female third-degree burn patient through ultrasonic examination in order to investigate the use of 25-mm Hg pressure garments, which are a key treatment for burns. The patient was injured with third-degree burns more than 10 years ago. Sixteen scars were examined. The resulting Pearson correlation of the forearm and upper arm was 0.138 (weak correlation; R 2 =0.0191). Therefore, in this case, all data points fell on a straight line with a positive (upward) slope. This result indicated different thicknesses for the upper arm and forearm third-degree burn scars; this result displays different thickness for the upper arms and forearm the third degree burn scars; the scars did not spread evenly due to the loading capacity of different parts of body instead of the pressure by pressure garment.This paper provides accurate information to manufacturers, therapists, and tailors regarding measurements for pressure garments. The results suggest that burn scars should be subject to appropriate pressure on the basis of medium scar height to avoid increasing scars and to stabilise burns, validating the hypothesis that 25 mmHg is not the optimal pressure for female patients with third-degree burns on the left arm and that the optimal pressure should be based on the patient's burns and wound area. To our knowledge, this is the first study to correlate the thickness of third-degree burns through ultrasound scan.

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“…It is thought that pressure creates a hypoxic environment that results in the impaired growth of myofibroblasts and inhibits factors that produce excess collagen (Li-Tsang, 2015;Anzarut et al, 2009). Despite the frequent use of pressure garments for scar reduction, the mechanisms of mechanical pressure and the way the pressure influences scarring is not fully understood Li-Tsang et al, 2015) Furthermore, the ideal amount of pressure necessary to be effective on burn scars and grafts is unclear (Engrav et al, 2010).…”

Section: Non -Surgical Interventions For Scar Reductionmentioning

confidence: 99%

“…They release cytokines which promote tissue regeneration by stimulating angiogenesis (the development on new blood vessels). In addition, they activate cells such as keratinocytes (the main skin cells) and specialised fibroblasts (myofibroblasts) that produce collagen to enhance wound closure (Guo & DiPietro, 2010;Li-Tsang et al, 2015). The myofibroblasts assist in the reestablishment of structural integrity to the injured tissue however, excessive and irregular deposition of collagen by these cells can result in a thickened scar (Li-Tsang et al, 2015).…”

Section: Inflammatory Phasementioning

confidence: 99%

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Interim pressure garment therapy: an investigation into the use of low level pressure therapy for burns donor site support and scar management

Donovan¹

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Split Thickness Skin Grafting (STSG) is a well-known and established procedure for healing burn wounds throughout the world. The procedure requires the removal of the epidermal and part of the dermal layer of the skin. It leaves intact the deep reticular dermal layer which is known as the donor site, and has sufficient cells to regenerate the excised superficial layers. STSG provides wound closure and accelerated healing for the burn wound, and there is great importance surrounding the success of graft take and scar management thereafter (Demirtas et al, 2009; Atiyeh et al, 2002). The presence of donor sites, though created to assist healing of the burn site, in fact creates an additional wound for the patient which often causes further psychological stress at a traumatic time in the healing process (Andrews, Brown, Drummond, & Wood, 2010). Donor sites are consistently identified as a particularly painful wound by burn patients. Pain associated with burn surgery has been shown to delay the patients return to work and daily functional activity (Wisley et al, 2010; Druery et al, 2005; Brown et al, 2008). Thus, protection of the remaining epidermal and dermal elements of this surgical wound (donor site) is required to assist effective tissue healing with minimal scarring. One intervention that may accelerate healing and reduce scar formation is the use of Interim Pressure Garment Therapy (IPGT) which applies 4-6mmHg of pressure to the thigh. This treatment has been utilised at a major Australian burns unit in Queensland by Occupational Therapists. However, this has involved inconsistent application with a focus on securing wound dressing rather than scar management. Despite this, anecdotal and observational evidence suggests that pressure therapy also makes a difference to some patient's scar outcomes for donor sites. It is hypothesised that IPGT may improve postoperative management of donor sites through the application of a low superficial pressure that mimics normal skin tension, possibly preventing donor wound distension and subsequent micro-tears in the newly forming epidermis. Furthermore, this may reduce the effects of the inflammatory response, which may in turn give rise to a hypertrophic scar response in the later stages of the healing process. This research focuses on a unique area of burns donor site scar management. It is designed to test a low pressure tubular support garment as an intervention for the support of, and reduction of donor site scarring. No known studies of this nature have been carried out to date, suggesting there is a need for rigorous clinical evidence to support the use of these garments for donor site scar minimisation. Thereby, two studies were undertaken. The objective of the first study was to determine the pressure range (mmHg) applied by the Interim Pressure Garment Therapy (IPGT). Forty seven healthy adult volunteers were measured and fitted with a pair of Interim Pressure Garments (IPG). s33634065 ii | P a g e The garments were made onsite from a tubular knit material, simil...

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A histological study on the effect of pressure therapy on the activities of myofibroblasts and keratinocytes in hypertrophic scar tissues after burn

Cited by 48 publications

References 37 publications

Compression Sleeves Design Based on Laplace Laws

Compression Sleeves Design Based on Laplace Laws

Fitted Pressure Garment of Assessment of Scar Thickness on Third-Degree Burns through Ultrasonic Measurement

Interim pressure garment therapy: an investigation into the use of low level pressure therapy for burns donor site support and scar management

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