Yu-Li SUNG, Physiotherapist and Director,
Medical Device Center of Sunshine Social Welfare Foundation
Pressure garments are probably the most commonly used tool to control post-burn hypertrophic scar growth. When burns cover an extensive area, our patients will need to wear multiple pieces to cover scars over different areas, with each piece overlapping on each other. In a previous article, we saw that wear sequence had an impact on the therapeutic effect of pressure therapy. But how these garments overlap also has an impact. We explain two key points for pressure garment overlapping that the therapist must consider.
Why should we pay attention to overlapping areas?
When using pressure garments, we want to maintain a constant and adequate level of pressure over scars. Let’s suppose that our patient with scars on the hand and forearm needs to wear gloves and separate sleeves. The overlapping area of the glove and separate sleeve will be at the wrist.
Because the garments are separate pieces, when the patient moves, joint movement will pull on the garments and they might not remain securely in place, with the potential risk that scars will become exposed and not receive adequate pressure. Also, the area will receive pressure from two separate garments, with the potential risk that pressure becomes excessive.
1. Make sure scars always remain covered
To make sure that scars are always covered and do not become exposed from the pull of joint movements on the garments, it’s important that the overlapping area between two garments be at least 5cm so that there will be no gap between them while the patient is moving.
2. Make sure there is no excessive pressure on the overlapping area
Two garments overlapping will provide greater pressure over that area, with the risk of causing swelling. To avoid this, we usually make the circumference of the garment that is the outer layer a bit looser. In this example, the sleeve is worn over the glove and will overlap with it, so the edge of the sleeve overlapping with the glove will be a bit looser to avoid causing excessive pressure.
Finally, pay attention to any thickness or bulkiness of the overlapping area, as this can cause discomfort or, depending on the area, restrict the patient’s movements.