Pressure Garment and Silicone Therapy in Occupational Therapy

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). Occupational 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 garments used by New Zealand Occupational Therapists include:
·       http://www.jobst.com/
·        https://www.secondskin.com.au/products/compressiongarments

Silicone Therapy includes using silicone Gel Sheeting (SGS) products that act as an occlusive layer, trapping moisture in to hydrate the skin whilst in turn reducing the scar colour, pliability and assists laying collagen down flat (Mustoe, 2008). SGS products have specific characteristics and recommendation for use. Cica Care explained: 
http://www.smith-nephew.com/new-zealand/healthcare/products/product-types/cica-care-/

Occupational Therapists implement SGS treatment with clients experiencing hypertrophic scarring, as it is easy to apply, painless, improves scar cosmetics, reduces redness and is used under pressure garments (Fette, 2006). New Zealand vivo study tested the successfulness of SGS products and findings demonstrated a significant reduction of 30% in epidermal thickness and 70% in scar hypertrophy after 2 weeks (Tandara & Mastoe, 2008). 

The 7-minute educational video below explains the use of additional scar management techniques including scar massage, stretch and splinting in occupational therapy practice.

University of Lowa Health Care (2014). 

References
Anzarut, A., Olson, J., Singh, P., Rowe, B. H., & Tredget, E. E. (2009). The effectiveness of Pressure Garment Therapy for the prevention of abnormal scarring after burn injury: A meta-analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 62(1), 77-84. doi: 10.1016/j.bjps.2007.10.052
Atiyeh, B. S., El Khatib, A. M., & Dibo, S. A. (2013). Pressure Garment Therapy (PGT) of burn scars: Evidence-based efficacy. Annals of Burns and Fire Disasters, 26(4), 205. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978593/
Bloemen, M. C., Van der Veer, W. M., Ulrich, M. M., Van Zuijlen, P. P., Niessen, F. B., & Middelkoop, E. (2009). Prevention and curative management of hypertrophic scar formation. Burns, 35(4), 463-475. doi: 10.1016/j.burns.2008.07.016
Fette, A. (2006). Influence of silicone on abnormal scarring. Plastic Surgical Nursing, 26(2), 87-92. doi: 10.1097/00006527-200604000-00010 
Mustoe, T. A. (2008). Evolution of silicone therapy and mechanism of action in scar management. Aesthetic Plastic Surgery, 32(1), 82-92. doi: 10.1007/s00266-007-9030-9 
Tandara, A. A., & Mustoe, T. A. (2008). The role of the epidermis in the control of scarring: Evidence for mechanism of action for silicone gel. Journal of Plastic, Reconstructive & Aesthetic Surgery, 61(10), 1219-1225. doi: 10.1016/j.bjps.2008.03.022
University of Lowa Health Care. (2014, March 7). Burn Unit Series - "Stretching, Scar Management, and Compression" [Video file]. Retrieved from https://www.youtube.com/watch?v=da389tmq62g

Comments

  1. Unknown25 July 2017 at 21:19

    Interesting read! I had no idea that pressure garments and silicone therapy was used by OTs. I enjoyed the video link there as well!

    ReplyDelete
    Replies
    1. Lauren Bromley26 July 2017 at 15:32

      Thank you for your comment it is nice hearing my audiences feedback. There is lots of evidence based practice literature out there, which supports other intervention Occupational therapist used in the management of scarring. Below are some additional references regarding other scar management techniques occupational therapist use in practice to treat excessive scarring, that you may be interested in exploring:

      Edgar, D., & Brereton, M. (2004). ABC of burns: Rehabilitation after burn injury. BMJ: British Medical Journal, 329(7461), 343. Retrieved from: https://scholar.google.co.nz/scholar?q=ABC+of+burns:+Rehabilitation+after+burn+injury&hl=en&as_sdt=0&as_vis=1&oi=scholart&sa=X&ved=0ahUKEwibqJGLgKjVAhXIl5QKHQlxAXkQgQMIJDAA

      Mustoe, T. A., Cooter, R. D., Gold, M. H., Hobbs, F. D., Ramelet, A. A., Shakespeare, P. G., ... & Ziegler, U. E. (2002). International clinical recommendations on scar management. Plastic and reconstructive surgery, 110(2), 560-571. doi: 10.1097/00006534-200208000-00031

      Delete
  2. muttonfriedcharga31 March 2022 at 10:42

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