Interim pressure garment therapy (4-6 mmHg) and its effect on donor site healing in burn patients: study protocol for a randomised controlled trial.
BACKGROUND
Pressure garment therapy (PGT) is well accepted and commonly used by clinicians in the treatment of burns scars and grafts. The medium to high pressures (24-40 mmHg) in these garments can support scar minimisation, and evidence is well documented for this particular application. However, PGT specifically for burn donor sites, of which a sequela is also scarring, is not well documented. This study protocol investigates the impact of a low pressure (4-6 mmHg) interim garment on donor site healing and scarring. With a primary purpose of holding donor dressings in place, the application of the interim pressure garment (IPG) appears to have been twofold. IPGs for donor sites have involved inconsistent application with a focus on securing wound dressing rather than scar management. However, anecdotal and observational evidence suggests that IPGs also make a difference to some patient's scar outcomes for donor sites. This study protocol outlines a randomised controlled trial designed to test the effectiveness of this treatment on reducing scarring to burn donor sites.


METHODS
This study is a single-centre, single (assessor)-blinded, randomised control trial in patients with burns donor sites to their thighs. Patients will be randomly allocated to a control group (with no compression to donor sites) or to an experimental group (with compression to donor sites) as the comparative treatment. Groups will be compared at baseline regarding the important prognostic indicators: donor site location, depth, size, age, and time since graft (5 days). The IPG treatment will be administered post-operatively (on day 5). Follow-up assessments and garment replacement will be undertaken fortnightly for a period of 2 months.


CONCLUSIONS
This study focuses on a unique area of burns scar management using a low-pressure tubular support garment for the reduction of donor site scars. Such therapy specifically for donor scar management is poorly represented in the literature. This study was designed to test a potentially cost-effective scar prevention for patients with donor sites to the thigh. No known studies of this nature have been carried out to date, and there is a need for rigorous clinical evidence for low-pressure support garments for donor site scar minimisation.


BACKGROUND
Australian New Zealand Clinical Trials Registry identifier ACTRN12610000127000 . Registered 8 Mar 2010.
Occupational Therapy Department, Royal Brisbane and Women's Hospital, Level 2, Dr James Mayne Building, Herston, QLD, 4029, Australia. michelledonovan@live.com.au.|Burns, Trauma & Critical Care Research Centre, School of Medicine, University of Queensland, Herston, QLD, 4029, Australia. michelledonovan@live.com.au.
Michelle L
ML
Donovan
Burns, Trauma & Critical Care Research Centre, School of Medicine, University of Queensland, Herston, QLD, 4029, Australia.|Professor Stuart Pegg Adult Burns Centre, Royal Brisbane & Women's Hospital, Level 4, Dr James Mayne Building, Herston, QLD, 4029, Australia.
Michael J
MJ
Muller
Professor Stuart Pegg Adult Burns Centre, Royal Brisbane & Women's Hospital, Level 4, Dr James Mayne Building, Herston, QLD, 4029, Australia.
Claire
C
Simpson
Burns, Trauma & Critical Care Research Centre, School of Medicine, University of Queensland, Herston, QLD, 4029, Australia.|Professor Stuart Pegg Adult Burns Centre, Royal Brisbane & Women's Hospital, Level 4, Dr James Mayne Building, Herston, QLD, 4029, Australia.
Michael
M
Rudd
Burns, Trauma & Critical Care Research Centre, School of Medicine, University of Queensland, Herston, QLD, 4029, Australia.|School of Allied Health Sciences, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.
Jennifer
J
Paratz
D002056:Burns / Q000473:pathology / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D002985:Clinical Protocols; D058128:Compression Bandages; D003646:Debridement; D006801:Humans; D011312:Pressure; D011446:Prospective Studies; D011793:Queensland; D012107:Research Design; D016037:Single-Blind Method; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods*; D000072836:Surgical Wound / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D060053:Transplant Donor Site; D016896:Treatment Outcome; D014945:Wound Healing
Burns; Donor site; Interim compression garment; Occupational therapy