Purpose: This case study and evidence-based analysis aims to determine if pressure garment therapy (PGT) is more effective than no pressure or other modalities for the treatment of hypertrophic scars in burned patients. Background: PGT has been a first-line conservative therapy for hypertrophic scarring since the early 1970s, however the research presents conflicting results and lacks consistency with study characteristics. With a myriad of possible side effects and limitations, research on PGT needs to be reanalyzed and its true potential determined. Case Description: The patient selected for this case study and analysis is a 49-year-old woman, admitted to the University of New Mexico Hospital (UNMH) on June 20th, 2012, with full thickness burns on approximately 86% of her total body surface area. Her long term treatment will need to include interventions for abnormal scar formation, which will most likely include PGT. Outcomes: A review of the current literature revealed that PGT can reduce the thickness or height of hypertrophic scars with the greatest effects seen in the first month of treatment. PGT has no statistically significant effect on erythema, pruritus or rigidity. The mechanism of action and optimal pressure for garments remains hypothetical. Integrating the results from all the included studies became apparently unlikely as each study varied considerably and many essential characteristics were commonly not reported. Discussion: The overall quality of the current research is poor and consistently lacks good external validity. While PGT was shown to have no effect on all the characteristics of hypertrophic scars, additional benefits may exist. These possible benefits, the potential side effects and cost should all be considered and discussed with the patient before prescribing PGT for hypertrophic scarring.
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burn, hypertropic scar, pressure garment, compression therapy, burn scar, scarring
Davis, Hayley. "Pressure Garment Therapy and Hypertrophic Burn Scars." (2014). http://digitalrepository.unm.edu/dpt/42