Pressure and Silicone Therapy Influence on Occupational Performance and Self-Efficacy

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 enables individuals to re-develop confidence in themselves and belief in their ability to accomplish tasks (self-efficacy). Additionally, post PGT and SGS intervention individuals report experiencing less stigmatisation, judgement and stares when in public (Engray et al, 2010). This increases an individual’s occupational participation in social situations as they feel more confident and don’t feel like they are being judged.

PGT and SGS demonstrate significant reductions in scar tension, scar height and increases the elasticity of scar tissue. Promoting functional improvements including increased range of motion, inhabits tight or pulling feeling of the scar experienced during movements and helps in the prevention of scar contractures (Steinstraesser et al, 2011). Treatment interventions enable individuals in gaining more functional range of motion of the joint affected and strength to complete tasks which were previously limited (Harte, Gordon, Shaw, Stinson, & Porter-Armstrong, 2009).  Increasing the individual’s participation and independence to engage in activities of daily living and functional occupational tasks.

It is recommended that combined PGT and SGS should be implemented on scarring by Occupational Therapists to enhance cosmetic appearance and functional engagement, additionally helping to reduce treatment times and improving patient quality of life (Li-Tsang, Zheng, & Lau, 2010).

References:
Steinstraesser, L., Flak, E., Witte, B., Ring, A., Tilkorn, D., Hauser, J., ... & Al-Benna, S. (2011). Pressure garment therapy alone and in combination with silicone for the prevention of hypertrophic scarring: Randomized controlled trial with intraindividual comparison. Plastic and Reconstructive Surgery, 128(4), 306e-313e. doi: 10.1097/prs.0b013e3182268c69 
Li-Tsang, C. W. P., Zheng, Y. P., & Lau, J. C. (2010). A randomized clinical trial to study the effect of silicone gel dressing and pressure therapy on posttraumatic hypertrophic scars. Journal of Burn Care & Research, 31(3), 448-457. doi: 10.1097/bcr.0b013e3181db52a7 
Engrav, L. H., Heimbach, D. M., Rivara, F. P., Moore, M. L., Wang, J., Carrougher, G. J., ... & Gibran, N. S. (2010). 12-Year within-wound study of the effectiveness of custom pressure garment therapy. Burns, 36(7), 975-983. doi: 10.1016/j.burns.2011.02.007 
Harte, D., Gordon, J., Shaw, M., Stinson, M., & Porter-Armstrong, A. (2009). The use of pressure and silicone in hypertrophic scar management in burns patients: A pilot randomized controlled trial. Journal of Burn Care & Research, 30(4), 632-642. doi: 10.1097/bcr.0b013e3181ac01a3 


Comments

  1. haylee26 July 2017 at 14:50

    So interesting! great intervention to improve confidence and get people re-engaging in meaningful occupations!

    ReplyDelete
    Replies
    1. Lauren Bromley26 July 2017 at 16:10

      Thank you so much for your comment it is so nice getting to hear my audiences feedback and opinion on the use of these interventions.

      Delete

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