OT Scar Management

This blog discusses the effects of Pressure Garment Therapy (PGT) and Silicone Gel Sheeting (SGS) in the treatment of burns and scars, highlighting the impact these interventions have on an individual’s occupational performance, cosmetic outcomes and self-efficacy. I chose to develop a blog on Burn and Scar Management in Occupational Therapy to highlight my strong passion to work with clients experiencing excessive scarring, to facilitate functional engagement in meaningful and purposeful occupations, with a vision for challenging social stigmatisation to facilitate social interaction and acceptance within clients’ communities. Prior to writing this blog I had some knowledge of how PGT and SGS is successful in improving cosmetic and functional outcomes on a stand-alone basis from Fieldwork 4 experience. There were aspects when developing this blog that I found difficult. This included being given complete creative license with developing the blog. This was very difficult for me as...

He can see, hear and breathe, he is alive!   Figure 1  - ( Mark Taylor (n.d) Fairfax New Zealand [image]. Retreived from: http://www.stuff.co.nz/business/79554323/fatal-hamilton-icepak-explosion-site-for-sale-a-new-start-for-tamahere-residents) David Beanland, a professional New Zealand firefighter, based at the Hamilton Central Fire Station recalls the day 9 years ago, when red watch crew pulled up to Tamahere's Icepak Coolstores, to what was thought to be a routine call out. But instead the entire Coolstore exploded without warning, seriously injuring seven firemen including David and killing another highly respected, experienced, long serving member of the New Zealand Fire Service. Although David’s protective firefighter gear saved most of his body, his face, head and hands bore the brunt of the explosion. He sustained serious burns to the posterior aspect of both hands and his head, requiring skin grafts both meshed and flat sheet. and the new don...

Evidence shows, in combining pressure garnment therapy (PGT) and silicone gel sheeting (SGS) interventions in therapy it reduces scar thickness, pliability, pigmentation, pain and itch after 2 months of application (Li-Tsang, Zheng, & Lau, 2010). Therefore, implying that combined therapy may stimulate earlier scar responses helping to lay collagen down flat, preventing raised hypertrophic scarring from developing. What does this mean for an individual’s occupational performance, cosmetic outcomes and self-efficacy when using PGT and SGS in conjunction? Demonstrates significant reduction in scar thickness, erythema (redness of the skin), pigmentation and itch (Steinstraesser et al, 2011). Promoting visual improvements in scar colour, thickness, and scar appearance as seen below: Figure 1 - An example of scar in combined therapy group at (A) initial assessment and (B) 6-month follow-up (Li-Tsang, Zheng, & Lau, 2010, p. 449). The subtle appearance of the scar enabl...

Qualitative pair-reviewed journal article examines the influence of scarring on patient’s quality of life in relation to the psychological impairments influencing cosmetic appearance and self-efficacy: And physical impairments causing restrictions to occupational participation (Bock, Schmid-Ott, Malewski & Mrowietz, 2006). The study determined the scar symptoms which influence individuals home life, personal relationships, occupational difficulties, social life, leisure pursuits, emotional reactions and self-confidence, which have been outlined below: Physical Symptoms  Social Symptoms  -   Tight / pulling sensation when scaring is present over a joint, leads to impaired range of motion, strength, occupational engagement and performance of activity of daily living. -   Contractors -   Stigmatisation -   Decreased self-confidence -   Interrupts / interferes with communication - Declined participa...

Pressure garments are designed to stimulate the skin, scar and underlying tissue. Continuous wearing of the garments 23 hours per day aids in reducing the scar formation and thickening of the scars, which in turn reduces the ‘lumpy bumpy’ raised appearance of the scar (Bloemen, Van der Veer, Ulrich, Van Zuijlen, Niessen, & Middelkoop, 2009) Pressure garments are either custom made or ready to wear garments made from elasticized fabrics. Individuals start Pressure Garment Therapy (PGT) post wound healing, they fit tightly, like a second skin applying a firm even pressure to the affected skin (Anzarut, Olson, Singh, Rowe, & Tredget, 2009). O ccupational Therapists use PGT as it has desirable treatment effects with few complications.                 Upper Body Pressure Garment (n.d) Head [image]  Received from: https://www.secondskin.com.au/Products/upper_body Australia based companies which supply a range of pressure g...

It is an Occupational Therapists’ role to provide high quality, person-centred Burns and Scar Management Therapy to people of all ages experiencing excessive scarring. Therapist aims to decrease the cosmetic appearance and facilitate engagement in functional activities and movement (Edgar & Brereton, 2004): and is achieved through education and non-invasive intervention techniques including: scar massage, pressure garments, silicone gel sheeting, splinting and stretch (Monstrey et al, 2014).  Scar management began from Ancient Egyptians belief that raw honey could treat wounds, infections and prevent scarring (Richard & Staley, 1994). As an Occupational Therapist, I have a strong passion to work with client’s experiencing excessive scarring to facilitate functional engagement in meaningful and purposeful occupations, with a vision for challenging social stigmatisation to enhance social interaction and acceptance within client’s communities.  Scarring is a form...