Abstract
BackgroundPressure 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/designThis 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.DiscussionThis 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.Trial registrationAustralian New Zealand Clinical Trials Registry identifier ACTRN12610000127000. Registered 8 Mar 2010.
Highlights
Pressure garment therapy (PGT) is well accepted and commonly used by clinicians in the treatment of burns scars and grafts
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
Primary objectives This research study aims to establish evidence for tissue support (4–6 mmHg) in healing burn donor sites and to test the use of interim garments made from tubular support bandages for donor site scar management
Summary
Pressure garment therapy (PGT) is well accepted and commonly used by clinicians in the treatment of burns scars and grafts. The surgery involves removing the burned or dead skin (debriding) and replacing it with a thin section of unburned healthy skin (donor skin), known as a split-thickness skin graft (SSG) This donor skin is surgically removed, commonly from the patient’s own thigh area, using a dermatome at a measure of 8/1000 inch to 12/1000 inch (depending on the thickness required to heal the burn defect) and includes the epidermis and the upper third of the dermis [4, 5]. Interim pressure garments (IPGs) for donor sites are routinely provided to inpatients at the Professor Pegg Adult Burns Centre, as early as day 1 postoperatively with a focus on securing wound dressings rather than scar management
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