An easy solution for areas that don’t receive enough pressure.
Yu-Li SUNG, Director, Medical Device Center,
Sunshine Social Welfare Foundation
Why would you need pockets in the first place?
Pressure garments are a widely used tool in post-burn scar management. Although pressure garments have many advantages, they still have some limitations, one of which is their reduced efficiency over concave areas. Inserts will usually be used to compensate the lack of pressure. Inserts are often made with otoform, silicone gel sheet or colloidal dressing, the cost of this type of insert can be expensive and they are not easily available in every country. Because of the impermeable characteristics of these materials, using them sometimes causes skin maceration or even allergic reaction. In addition, inserts that are not adhesive like otoform will tend to move and will not remain in place in certain areas of the body. This is often the case for scars around the ankle, especially around medial and lateral malleolus.
Sewing a simple pocket on the pressure garment is relatively easy solution to these problems. Because the insert used inside the pocket can be made with sponge or thick fabric, it is relatively inexpensive, and the pocket will make sure that the insert stays in place.
Do you want to try it? Here’s the material that you’ll need
Whether your patient uses custom-made pressure garments or ready-made ones, adding a pocket is pretty straightforward. You will need:
Pressure garment fabric (if pressure garment fabric is not available, any other soft fabric with elasticity can be used)
Insert (sponge or thick fabric or any other kinds of inserts)
Scissors or pinking shears
Thread
Needle
There are just three fabrication steps (we told you it would be easy!)
Based on the contour of the area where we want to increase pressure through the use of insert, and also based on the scar’s condition, cut a piece of pressure garment fabric or any other soft fabric. If the fabric frays easily, pinking shears can be used because it cuts the fabric on the bias, and this will stop some fraying.
Stitch the piece of fabric inside the pressure garment, leaving an opening to place the insert.
To make the insert, cut a piece of sponge the desired size and shape. If using fabric, pieces of fabric can be stitched together to achieve the desired thickness of insert.
Place the insert inside the pocket and you’re done!
In these photos, the pocket has been stitched inside a pressure garment sock to use an insert over the malleolus but this kind of pocket can be used in other areas such as the c
hest, the palm of the hand, the arch of the feet or any other area that would benefit from more pressure.
It’s also easy to care for!
Before washing the pressure garment, remove the sponge or fabric insert. Put it back in place once the pressure garment is dry. That’s it!
What are precautions or contraindications?
There are no contraindications but it’s important to remember that the pocket will be stitched inside the garment and be in direct contact with the skin, therefore we need to avoid causing friction over the scar. This means using a fabric that is soft enough and also avoiding thick, bulky stitches that might also cause friction.
Author: Yu-Li SUNG (PT), Director, Medical Device Center, Sunshine Social Welfare Foundation
Reference: Yu-Li Sung, Pressure Garment Pocket for Insert, Burns Open, Volume 5, Issue 4, October 2021, Pages 228-229 View article online
For more tips, how to's and videos about burn rehabilitation, visit Sunshine Training Youtube channel.
For more great burn rehabilitation innovations from around the world, visit the special issue of Burns Open Innovative Solutions in Burn Rehabilitation from Around the World.