BURNSCAR HYPERTROPHY

Thick hypertrophic burn scars can usually be prevented by prolonged, constant, external pressure. Such treatment is not necessary after burn wounds, but is strongly indicated when there is deep, partial-thickness (severe second degree) involvement or after grafting for full-thickness burns. Custom Jobst garments are available to provide this pressure. They can be made for virtually every area of the body and are always of elastic material. In terms of the benefits these garments seem to offer, many believe they are literally worth their weight in gold. Each patient is usually fitted with a minimum of two garments so that one can be worn while the other is being laundered. They must be worn constantly. Only for bathing and physical therapy should they be removed. These should be worn for one year and occasionally longer until scar maturation has been completed. 

PRESCRIBING A BURN GARMENT

Burn garments may be ordered by a nurse or therapist, at the direction of the physician, as soon as the patient can tolerate light pressure. Early in the first stages of healing, an elastic wrap and elasticized stockinet can be used to help control edema and support the tissues when ambulating.

During the intermediate phase when the wounds are healing but not able to tolerate therapeutic pressures, Jobskin Interim Care Garments are available. Designed to give light pressures tolerable to newly healing skin, they come in predetermined sizes fitting toddler to adult. Interim Care Garments are worn until the patient’s weight has stabilized, edema has been reduced and the wounds have closed. After wound closure is complete, the patient is ready for maximum pressure. The healed tissue is better able to tolerate the higher pressure custom-fitted garments provided. At this time, measuring for the continuing care garments may begin. This phase represents the most aggressive stage of the burnscar management.

Burn garments are custom-engineered and constructed, for each patient, to provide continuous application of effective pressure to the maturing burnscar area.  Based on biomedical engineering principles, precise measurements of the patient's involved areas must be taken.   The measurements are used to develop a pattern for the elastic garment.  Each one is custom-made from a pre-tensioned, spandex and nylon fabric.   Conventional elastic garments and wraps, because they are not designed to the exact measurements of a burn victim's body, cannot apply the known and precise counterpressures. 

Applied early and maintained in a rigorous program of continuous use, Burn garments offer a significant non-surgical approach to the minimization of hypertrophic scars during burnscar maturation.