29 Jun The Use of Pressure Garments
Following a severe burn injury where the outer layer and part of the dermis is destroyed, you may be told to wear a pressure garment to prevent and control excess scar formation, and ensure a smooth and flat healing of the skin surface.
Undamaged skin is composed of collective tissues in the dermis. These tissues for a three-dimensional web of collagen fibers aligned parallel to the skin’s surface. Skin applies delicate pressure against its underlying layers. This subtle pressure ensures that injured skin is replaced in its original state without scarring. In severely burned skin, the kind of scarring that can occur is called hypertrophic.” When the skin is destroyed by burns, the normal pressure of the papillary dermis no longer exists and hypertrophic scarring will occur. Irregular hypertrophic scarring is characterized by excessive amounts of collagen which create a raised scar. Often hypertrophic scars appear angry – they are thick, red, itchy and/or painful. When located close to a joint, they can even restrict movement. Pressure garments prevent and control the formation of hypertrophic scarring by applying pressure to the wound. By minimizing the effects of hypertrophic scarring, pressure garments reduce scarring and any subsequent deformities.
Scar tissue is highly responsive in the early stages, so an early application of pressure garments is imperative. Pressure garments should be used as soon as your wounds are healed and are strong enough to take pressure without breaking down. Burn survivors must begin wearing pressure garments while the scar is immature and active. They are generally worn until the scar matures, anywhere from 12 to 18 months. A change in both the color and texture of the scar indicates when the scar has reached maturity. Once mature, the deep color of the scar will fade to a paler shade of your normal skin. It will also remain smooth instead of lumpy, when the pressure garment is removed for any length of time. Pressure garments should be worn for at least 23 hours a day, and should only be removed for bathing, lubricating, and cleaning.
Pressure garments are custom made for you. They are made out of a resilient poly cotton or Lycra material. Expect them to fit very snugly while they apply a constant and firm pressure to your skin. The external pressure applied by the pressure garment will reduce the amount of blood in the scar, resulting in less production of collagen. Wearing pressure garments can decrease an itching sensation.
What to Be Aware of When Wearing Pressure Garments:
- Difficulty in putting them on – bathing and applying moisturizing cream first will help them slide on.
- Tight Feeling – it takes a few weeks to get used to this feeling of tightness
- Itchiness – the natural healing process, coupled simply with your skin getting hot under the garment, can cause itchiness. Wearing cotton clothing can ease this.
- Soreness – garments rubbing together can cause soreness. Stop wearing the garment if this occurs and consult your therapist for help.
- Pressure garments need to fit tightly in order to work properly, but they should never affect your circulation. Contact your therapist if you develop any rashes, breakdown of the skin, numbness, a “pins and needles feeling,” or blue discoloration.
Caring for Pressure Garments
- Discuss with your therapist how to best put them on, remove them, and launder them
- Make sure they fit correctly – again they have to fit and feel tight to work
- Hand-wash your garments in warm water daily. Rinse them thoroughly, especially if you have worn them in chlorinated water or saltwater. To remove water, gently squeeze them and roll them in a towel to dry. Never wring them, dry them in the sun, or put them in the dryer. Let them dry at room temperature. Do not iron them
- If damaged, or zippers don’t function, contact your therapist
- Rub moisturizers completely into skin before putting on pressure garments. All creams and lotions will cause the fabric to break down
Pressure garments are an integral part of burn scar management, aiding in the prevention and control of excess scar formation. Despite the inconvenience and occasional discomfort, continuous wearing of pressure garments will help prevent the hardening, thickening, and lumpy appearance of your scars.
For more information about burn injuries please visit our website, www.burnsurvivor.com
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