PATHOPHYSIOLOGICAL ASPECTS OF COMPRESSION THERAPY USE FOR PREVENTION OF SCARS AFTER BURNS

Abstract

Mechanical squeezing of a skin cover by knitted clothes or its details is considered as the basic technological principle of compressive therapy. The definition of a level of squeezing the body by medical pressure clothes and manufacturing of an individual pattern for it sewing is offered to be carried out on the basis of physiologically adequate criteria of blood microcirculating of patients with various anthropometrical and functional blood pressure parameters with the help of the device - electronic tension-meter. Ischemization of the connective tissue parts of the scar, which is clinically confirmed by the foliation of the skin under compression elastic clothing, leads to a decrease in the mass of connective tissue and accelerated subsidence of the processes of inflammation and maturation of scar tissue. At the same time, the object affected by the compression therapy is the connective tissue that is formed, keeping the collagen fibers and fibroblasts in disorder. Creating a compression in excess of 25 mm Hg per cm2 in the early stages leads to a reduction in interstitial edema and limitation of excess formation of granulation tissue capillaries. According to the results of experimental and preliminary clinical studies, it was found that the optimum mechanical compression of the body tissues with elastic clothing is achieved by mechanical compression, which in quantitative terms corresponds to half of the average dynamic blood pressure, adjusted to the level of development of subcutaneous adipose tissue of the patient. In addition to the anatomical and physiological features of the structure of subcutaneous adipose tissue in different parts of the body, according to the results of clinical observations in people with different levels of vascular tone, it became necessary to take into account not only the average dynamic but also diastolic pressure, that largely determines the conditions of transcapillary blood exchange, resulting in additional compression of their outer compression clothing that can not only affect the level of local blood flow, but also the ability of hemodynamic function. While wearing medical clothing for compression therapy, the patient subjectively felt compression of the tissues, and objectively this was accompanied by mechanical pressure on the pressure sensor, and therefore – by switching on a light indicator, which indicated the achievement of the necessary mechanical impact on the compression therapy of the tissue. Thus, the suggested method provides a technological and accurate removal of the pattern of clothing for compression therapy, which will help to produce the optimal clothing size, and therefore to achieve the desired therapeutic effect.