Pressure therapy in the treatment of post-burn hypertrophic scar—A critical look into its usefulness and fallacies by pressure monitoring

Pressure therapy is generally accepted as the best non-invasive means of preventing and controlling hypertrophic scarring after burn injury. Most studies in the past have failed to correlate clinical response with magnitude of the garment-scar interface pressure.This study looked critically at our usual techniques of pressure therapy using pressure ‘sensors’ manufactured locally and based on electro-pneumatic principles. Many pitfalls, such as large variations of pressure at different geometric sites on the body, elastic deterioration in garments, problems of garment manufacture, and the unfavourable properties of the Lycra garments, were observed. Recommendations on pressure treatment were made based on our experiences, to improve the present technique of pressure therapy. These included the standardization of measurement techniques and garment tailoring, the regular checking of pressure at the garment-scar interface using pressure transducers, the appropriate garment adjustments, a strict regimen for garment wearing, and the intelligent use of pressure-padding and reinforcement. Areas of further research are also discussed.