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Pressure garment wearing sequence: Is sequence of wearing really important?

Yu-Li Sung, Physiotherapist and Director,

Medical device Center, 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. But did you know that there is a sequence for wearing garments that can impact the therapeutic effect of pressure therapy?


What do you think is the correct order for wearing these garments for the patient in the picture below?

1. Full mask, 2. glove with fingers, 3. short sleeve shirt, 4. separate long sleeve, 5. neck collar.

What do you think is the correct order for wearing these garments for the patient in the picture?

  • 0%A. 1, 3, 4, 2, 5

  • 0%B. 2, 4, 3, 1, 5

  • 0%C. 1, 5, 3, 4, 2

  • 0%D. 4, 3, 1, 5, 2

Continue reading to find out the correct answer…


What is the correct sequence for wearing multiple pressure garments?

The order for wearing pressure garments is from distal to proximal. Distal to proximal refers to starting from the areas furthest away from the center of the body and moving towards the center. When wearing pressure garments, this means starting at the fingers or toes and working upwards towards the trunk of the body.


Why is this sequence important?

The distal to proximal sequence is based on the principles of lymphatic drainage and blood flow. We all know that pressure garments apply vertical pressure on scars to control hypertrophic growth, but pressure is also beneficial to reduce edema. Edema is a normal response to trauma, and residual edema can occur in the post-acute phase, with fluid building up in affected areas, which can lead to further complications.


Wearing pressure garments can help stimulate lymphatic drainage and improve circulation in the affected area. By starting at the distal end and working towards the proximal end, the pressure exerted by the garment helps to move fluid towards the body's center, thus reducing edema. On the contrary, wearing garments from proximal to distal will end up moving fluids towards the extremities and may worsen edema.


So based on this principle, the correct answer is B.



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