Burns
Conditions
Keywords
Hypertrophic scarring, Silicone Material, Pressure garments
Brief summary
The purpose of this study is to determine if the use of silicone material inserts within pressure garments is effective in decreasing hypertrophic burn scar formation as compared to standard pressure garment therapy.
Detailed description
Surgical revision, potential hospitalization, and extensive post-surgical rehabilitation may be required for the revision and correction of hypertrophic burn scars to restore function and prevent disability. This in turn results in an increased financial burden to the medical system. More importantly, the patient is required to undergo an additional invasive medical procedure that can potentially create further hypertrophic scarring. Prevention and reduction of hypertrophic scars with non-invasive, cost effective, and evidence based treatment modalities is therefore the most desirable approach. Two of the most generally accepted methods of non-invasive treatment, pressure garments and silicone gel sheeting, have been demonstrated to individually treat hypertrophic scarring. Recently, burn therapists have begun to use silicone bonded material inserts within pressure garments following the logical deduction that the two therapeutic techniques can be combined to resolve many of the cited individual disadvantages, while reaping the benefits of each individual modality. It is the aim of this study to determine the efficacy of these silicone bonded material inserts within pressure garments in the treatment of hypertrophic scarring.
Interventions
DEVICEPressure garment and silicone insert
Custom made fabric pressure garment with textile bonded silicone insert on either proximal or distal portion of pressure garment.
DEVICEPressure garment
Custom made fabric pressure garment
Sponsors
Health Sciences Centre Foundation, Manitoba
University of Manitoba
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
16 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* patients who would normally receive pressure garments * presence of an acute burn to an upper or lower extremity that requires treatment with a sheet or meshed graft * Minimum 4% total body surface area graft dimension (this must include areas above and below the elbow or on medial and lateral aspects of the calf * Between 16 years and 60 years of age * Patient must consent to the study or obtain consent from guardian if \<18 years of age * Must be available for follow-up at 1 month, 3 months, 6 months, and 12 months post initiation of treatment
Exclusion criteria
* Presence of pre-existing hypertrophic or keloid scarring * Pressure garments initiated greater than 2 months post discharge from hospital * Pre-existing decrease in range of motion of affected extremity * One treatment area with a prolonged healing phase or which had been treated differently in comparison to adjacent treatment area * Patient unable to comprehend or participate in self reporting
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Scar pliability measured in gm/mm squared | A baseline evaluation will be performed at the time of initial pressure garment fitting, and follow up evaluations will take place at 1 month, 3 months, 6 months and 12 months after pressure garment fitting. | The Modified Vancouver Scar Scale (MVSS) will be used to measure the scar pliability. It is a therapist-judged hand held tool that measure scar properties on an ordinal scale. Because the MVSS is a subjective rating system, we will also be using the NK Skin Compliance Device (SCD)to measure scar pliability. It is a non-invasive hand-held device that measures skin compliance or pliability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Scar vascularity | A baseline evaluation will be performed at the time of initial pressure garment fitting, and follow up evaluations will take place at 1 month, 3 months, 6 months and 12 months after pressure garment fitting. | The Modified Vancouver Scar Scale (MVSS) will be used to measure the scar pliability. It is a therapist-judged hand held tool that measure scar properties on an ordinal scale. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Scar Appearance | A baseline evaluation will be performed at the time of initial pressure garment fitting, and follow up evaluations will take place at 1 month, 3 months, 6 months and 12 months after pressure garment fitting. | Will be measured using a visual analogue scale (VAS). |
| Scar height | A baseline evaluation will be performed at the time of initial pressure garment fitting, and follow up evaluations will take place at 1 month, 3 months, 6 months and 12 months after pressure garment fitting. | The Modified Vancouver Scar Scale (MVSS) will be used to measure the scar pliability. It is a therapist-judged hand held tool that measure scar properties on an ordinal scale. |
| Limitations to movement | A baseline evaluation will be performed at the time of initial pressure garment fitting, and follow up evaluations will take place at 1 month, 3 months, 6 months and 12 months after pressure garment fitting. | Will be measured using ordered response scales. |
| Comfort of garment | A baseline evaluation will be performed at the time of initial pressure garment fitting, and follow up evaluations will take place at 1 month, 3 months, 6 months and 12 months after pressure garment fitting. | Will be measured using ordered response scales. |
| Scar itch | A baseline evaluation will be performed at the time of initial pressure garment fitting, and follow up evaluations will take place at 1 month, 3 months, 6 months and 12 months after pressure garment fitting. | Scar itch will be measured using a visual analogue scale (VAS). |
Outcome results
None listed