title: Burn Scar Biomechanics after Pressure Garment Therapy.
abstract: BACKGROUND
  The current standard of care for the prevention and treatment of scarring after burn injury is pressure garment therapy. Although this therapy has been used clinically for many years, controversy remains regarding its efficacy. The authors evaluated the efficacy of pressure garment therapy in a female red Duroc pig burn model in which wound depth could be tightly controlled.
  
  
  METHODS
  Full-thickness burn wounds were generated on female red Duroc pigs. At day 28 after burn, pressure garment therapy was applied to half the wounds (10 mmHg), with control wounds covered with garments that exerted no compression. Scar area, perfusion, hardness, and elasticity were quantified at days 0, 28, 42, 56, and 72 using computerized planimetry, laser Doppler, and torsional ballistometry. Scar morphology was assessed at days 28, 56, and 76 using histology, immunohistochemistry, and transmission electron microscopy.
  
  
  RESULTS
  Pressure garment therapy significantly hindered scar contraction, with control scars contracting to 64.6 percent + 13.9 percent original area at day 72, whereas pressure garment therapy scars contracted to 82.7 percent + 17.9 percent original area. Pressure garments significantly reduced skin hardness and increased skin strength by 1.3 times. No difference in perfusion or blood vessel density was observed. The average collagen fiber diameter was greater in control burns than in pressure garment therapy.
  
  
  CONCLUSIONS
  Pressure garment therapy was effective at reducing scar contraction and improving biomechanics compared with control scars. These results confirm the efficacy of pressure garments and highlight the need to further investigate the role of pressure magnitude and the time of therapy application to enhance efficacy for optimal biomechanics and patient mobility.
authors.affiliation: Columbus and Cincinnati, Ohio From the Departments of Biomedical Engineering, Materials Science and Engineering, and Surgery, the Center for Regenerative Medicine and Cell-Based Therapies, and the Comprehensive Wound Center, The Ohio State University; and the Research Department, Shriners Hospitals for Children.
authors.forename: Jayne Y
authors.initials: JY
authors.lastname: Kim
authors.forename: James J
authors.initials: JJ
authors.lastname: Willard
authors.forename: Dorothy M
authors.initials: DM
authors.lastname: Supp
authors.forename: Sashwati
authors.initials: S
authors.lastname: Roy
authors.forename: Gayle M
authors.initials: GM
authors.lastname: Gordillo
authors.forename: Chandan K
authors.initials: CK
authors.lastname: Sen
authors.forename: Heather M
authors.initials: HM
authors.lastname: Powell
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D002056:Burns / Q000150:complications / Q000628:therapy*; D002921:Cicatrix / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D058128:Compression Bandages; D005260:Female; D013552:Swine