Pressure Garments Research Articles

Structural effect of weft knitted pressure garments on applied pressure and thermal comfort properties

Structural effect of weft knitted pressure garments on applied pressure and thermal comfort properties

A Comparative Analysis of the Advances in Scar Reduction: Techniques, Technologies, and Efficacy in Plastic Surgery.

The study provides a comprehensive analysis of the latest methodologies and treatments aimed at improving scar management. Scar formation results from the replacement of normal skin with fibroblasts, leading to a structured unidirectional collagen bundle, as opposed to the collagen sheet matrix found in healthy skin. This review categorizes scars into hypertrophic scars and keloids, each with distinct pathophysiological characteristics. It highlights the importance of consistent scar assessment using scales such as the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale, emphasizing the need for standardized evaluation methods. The study systematically reviews various scar management techniques, ranging from traditional surgical methods to innovative treatments. Conventional approaches such as pressure garments and silicone gel sheeting are explored, noting their roles in maintaining hydration and occlusion. The efficacy of intralesional corticosteroid injections and laser therapies is discussed, with particular attention given to their combined use for optimal outcomes. The review also covers advanced techniques such as microneedling, platelet-rich plasma therapy, and stem cell-based treatments, detailing their mechanisms and potential benefits in scar remodelling. Additionally, the study underscores the emerging role of botulinum toxin A in both preventive and corrective scar treatments, offering promising results in reducing movement-induced scar exaggeration. The systematic review includes a thorough examination of existing literature, clinical trials, and meta-analyses to evaluate the effectiveness of these interventions. It concludes by calling for further research to refine these techniques and enhance their application in clinical practice, aiming to achieve better aesthetic and functional outcomes for patients with scars.

The effect of clothing pressure of calf compression garments on human leg muscles during running

PurposeThe few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running.Design/methodology/approachFive healthy amateur runners(three female and two male)were recruited for a 30-min running trial. They wear a Calf CG on their right leg (CG group), but not on their left leg(CON group). After obtaining the clothing pressure of Calf CG on the gastrocnemius lateral head (GL), gastrocnemius medial head (GM) and tibialis anterior(TA) of the right leg, surface electromyography (sEMG)of four muscles of GL, GM, TA and rectus femoris (RF) of the left and right legs were measured during running, and heart rate, cardiopulmonary rate, and human RPE were also measured. Blood bleed oxygen before and after the running trial were measured. The root mean square (RMS) of the characteristic values was selected as an index for the analysis of sEMG signals, and the data were analyzed using statistical and computational methods.FindingsThe results showed that the indexes of heart rate, blood oxygen, and RPE were significantly increased, indicating that the subjects had reached the fatigue level. The comparison of mean clothing pressure at GL, GM and TA locations reveals that the TA location consistently exhibits the highest pressure for both types of CG. When wearing CG1, the mean clothing pressure at the GL and GM test points is greater than that of CG2(CG1-GL = 0.2059 kPa > CG2-GL = 0.148 kPa; CG1-GM = 0.1633 kPa > CG2-GM = 0.127 kPa). This is attributed to the double-layered fabric on the sides of CG1, which precisely covers the GL and GM areas, thereby resulting in higher mean clothing pressure at these locations compared to CG2. Conversely, the mean clothing pressure at the TA location for CG1 is lower than that for CG2(CG1-TA = 0.3852 kPa < CG2-TA = 0.426 kPa). The pressure exerted by the CG1 on the lower limb test areas has both positive and negative effects, though neither are statistically significant. The pressure exerted by CG2 alleviates fatigue at the directly affected locations GL and GM, but exerts excessive pressure on TA, resulting in a negative effect. Additionally, CG2 pressure alleviates fatigue at the indirectly affected location RF on the same side. Based on the specific clothing pressure data, it is concluded that when the pressure at the GM location is 0.127 kPa, 30 min of running has a fatigue-relieving effect. However, the pressure should not be excessively high, at 0.1633 kPa it exhibits an insignificant adverse effect. At the TA location, a garment pressure mean between 0.3852 and 0.426 kPa does not alleviate fatigue after 30 min of running, and the negative effect becomes more pronounced as the pressure increases. The pressure exerted by the CG at GL, GM, TA and RF locations shows significant changes from the previous time period during the 15–18 min interval after running. Therefore, in the design of CG, attention should be paid to the changes in clothing pressure effects on muscles during this specific time period.Originality/valueThe few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running.

592 Pressure Garment Use by International Pediatric Patients During the COVID-19 Pandemic: A QI Study

592 Pressure Garment Use by International Pediatric Patients During the COVID-19 Pandemic: A QI Study

Improving cosmetic and functional outcome in case of post burn contracture of hand and fingers by using de-epithelized plantar skin graft

Background: Burn scar contractures in the fingers and hand often lead to debilitating functional and cosmetic issues. Various surgical approaches exist, but achieving optimal outcomes remains a challenge. While grafting glabrous split-thickness skin from the foot's plantar aspect is a well-established method, it remains underutilized, with conventional grafts leading to complications, especially in darker-skinned individuals. Method: This study involved 35 patients with McCauley grade II and III hand burn contractures, spanning various age groups and genders. Surgical procedures encompassed scar removal, contracture release, and plantar skin graft application. Post-operatively, patients received dressing, splinting, and physiotherapy. Donor site healing was evaluated at the 3-week mark. Results: Remarkably, all patients exhibited successful donor site healing within 3 weeks. The surgical technique effectively addressed contractures, enhancing range of motion and function. Post-operative care, featuring physiotherapy, coconut oil massages, and pressure garment use for at least 6 months, significantly contributed to post-burn hand and finger contracture management. Conclusions: De-epithelized plantar skin grafts offer a promising avenue for enhancing both aesthetics and function in individuals with post-burn hand and finger contractures. This technique minimizes complications common with traditional grafts while promoting successful donor site healing and improved range of motion. The study underscores the significance of using like-for-like reconstruction to achieve the best possible results in managing post-burn contractures.

Tuning the Tensile and Shear Properties of a Scar Healing Composite for Mechanotherapy

Conventional scar treatment options of single pressure garment therapy (PGT) or silicone gel sheeting (SGS, Cica-Care®, Smith and Nephew, London, UK) alone lack mechanical property tunability. This article discusses a scar healing composite (PGF-Biopor®AB, Dreve Otoplastik GmbH, Unna, Germany) and how its mechanical properties can be tuned for improved mechanotherapy. A balance between compression and tension was achieved by tuning the tensile and shear properties, facilitating tension shielding and pressure redistribution for scar therapeutics. Biopor®AB-wrapping on biaxial-tensioned pressure garment fabric (PGF) allowed compression therapy and internal pressure redistribution. The Biopor®AB surface, with a coefficient of friction close to 1, strategically localizes stress for effective tension shielding. A substantial five-fold reduction in silicone tension, amounting to 1.060 N, achieves tension shielding and pressure redistribution. Simultaneously, a dynamic internal pressure-sharing mechanism distributes 0.222 kPa from each SPK-filament bundle, effectively managing internal pressure. Alongside the principle compression-silicone dual therapy, this composite design with dynamic internal pressure sharing and mechanical property tunability provides an additional pressure-relieving strategy for multiple scar therapeutics.

Efficacy and Cytocompatibility of a Pressure Garment—Silicone Composite Dressing Material for Scar Healing

Efficacy and Cytocompatibility of a Pressure Garment—Silicone Composite Dressing Material for Scar Healing

The Molecular Mechanisms Involved in the Hypertrophic Scars Post-Burn Injury.

Scar formation is a normal response to skin injuries. During the scar-remodeling phase, scar tissue is usually replaced with normal, functional tissue. However, after deep burn injuries, the scar tissue may persist and lead to contractures around joints, a condition known as hypertrophic scar tissue. Unfortunately, current treatment options for hypertrophic scars, such as surgery and pressure garments, often fail to prevent their reappearance. One of the primary challenges in treating hypertrophic scars is a lack of knowledge about the molecular mechanisms underlying their formation. In this review, we critically analyze studies that have attempted to uncover the molecular mechanisms behind hypertrophic scar formation after severe burn injuries, as well as clinical trials conducted to treat post-burn hypertrophic scars. We found that most clinical trials used pressure garments, laser treatments, steroids, and proliferative inhibitors for hypertrophic scars, with outcomes measured using subjective scar scales. However, fundamental research using human burn injury biopsies has shown that pathways such as Transforming Growth factor β (TGFβ), Phosphatase and tensin homolog (PTEN), and Toll-like receptors (TLRs) could be potentially regulated to reduce scarring. Therefore, we conclude that more testing is necessary to determine the efficacy of these molecular targets in reducing hypertrophic scarring. Specifically, double-blinded clinical trials are needed, where the outcomes can be measured with more robust quantitative molecular parameters.

Analysis of the tensile stress relaxation of weft-knitted medical compression fabrics in view of the fabric structure

Stress relaxation will create interference in the performance of textiles in applications such as compression garments, pressure bandages, and varicose stockings in which keeping a definite level of pressure on the scar area is vital. Therefore, considering the effectual parameters on the stress relaxation of the fabrics will help to produce appropriate functional clothes. In this research, rib-knitted fabrics with different numbers of tuck stitches in successive wales have been fabricated and their stress relaxation has been surveyed. According to the findings, in all fabric structures, stress relaxation is higher in the wale direction compared to the course direction. In both directions, the stress relaxation linearly changes with the number of tuck stitches in the fabric structure. By increasing the number of tuck stitches, the stress relaxation of the fabric increases from 43% to 81% in the course direction whilst decreasing from 47% to 82% in the wale direction. Consequently, utilization of the tuck stitch in the structure of pressure bandages enhances their functionality, whilst diminishing the performance of compression garments and varicose stockings. Therefore, the use of knitted fabric consisting of tuck stitches is not recommended for pressure garments and varicose stockings.

Accuracy prediction of wearable flexible smart gloves

Abstract This article aimed at providing a new biomechanical three-dimensional dynamic finite element model of the hand–glove combination for exploring the distribution of the overall continuous dynamic contact pressure of the hand with the flexible glove in the state of grabbing an object, and further predicting the accuracy of sensors of wearable smart gloves. The model was validated by garment pressure experiments at eight muscle points. The results showed that the pressure value measured with three flexible gloves was highly consistent with the finite element simulation value. Based on the model, the distribution of dynamic pressure between the soft tissue of the hand and the fabric in the process of flexing the fingers and grabbing external objects were predicted accurately and effectively, which indicated that the model with high accuracy could be applied to evaluate the accuracy of the pressure value collected by sensors of smart gloves. In addition, the model had been confirmed that it has a certain application value. The findings could help to provide a reference for dynamic continuous monitoring equipment or other intelligent wearable devices, and promote the development of the intelligent clothing industry in the future.

NRP1 transduces mechanical stress inhibition via LATS1/YAP in hypertrophic scars

Hypertrophic scar (HS) is an abnormal fibrous hyperplasia of the skin caused by excessive tissue repair in response to skin burns and trauma, which restricts physical function and impairs patients’ quality of life. Numerous studies have shown that pressure garment therapy (PGT) is an effective treatment for preventing hypertrophic scars. Herein, we found that mechanical stress stimulates the neuropilin 1 (NRP1) expression through screening GSE165027, GSE137210, and GSE120194 from Gene Expression Omnibus (GEO) database and bioinformatics analysis. We verified this stimulation in the human hypertrophic scar, pressure culture cell model, and rat tail-scar model. Mechanical compression increased LATS1 and pYAP enrichment, thus repressing the expression of YAP. Functionally, the knockdown of NRP1 promoted the expression of LATS1, thus decreasing the expression of YAP and inhibiting endothelial cell proliferation. Furthermore, co-immunoprecipitation analysis confirmed that NRP1 binds to YAP, and mechanical compression disrupted this binding, which resulted in the promotion of YAP relocation to nuclear. In conclusion, our results indicated that NRP1 transduces mechanical force inhibition by inhibiting YAP expression. Mechanical pressure can release YAP bound to NRP1, which explains the phenomenon that mechanical stress increases YAP in the nucleus. Strategies targeting NRP1 may promote compression therapy with optimal and comfortable pressures.

A therapeutic evaluation of various modalities of treatment of keloid-A randomized open label study

Keloid and hypertrophic scar are the result of abnormal growth of fibrous tissue following healing of a cutaneous injury in predisposed individuals. Some treatment options are pressure garments, radiation therapy, excision, intralesional injections, cryotherapy, silicone gel dressing and lasers though no single modality is completely effective.To study the efficacy, to compare and to study the adverse effects of 4 different modalities of treatment of keloid namely, Intralesional triamcinolone acetonide (TAC), Intralesional triamcinolone acetonide and 5-fluoro uracil (5-FU), Intralesional triamcinolone acetonide and silicone gel sheet (SGS) and Intralesional Radiofrequency (RF). Arandomized open label study was conducted in the dermatology department of a tertiary care hospital in Gujarat from Nov 2020 to December 2022. 108 patients were allocated to 4 groups, Group 1(TAC), Group 2( + 5FU), Group 3( + SGS) and Group 4(RF). Group 1 received Intralesional injections of Triamcinolone acetonide (alone), Group 2 received Intralesional injections of Triamcinolone acetonide and 5- fluorouracil, Group 3 was given Intralesional injections of Triamcinolone acetonide and topical silicone gel sheet and Group 4 was treated with intralesional radiofrequency.A total of 108 patients of age group 18-52 years were enrolled and was divided into 4 groups consisting of 27 patients each Improvement of pliability, vascularity, pigmentation and height of keloid was maximum in TAC + 5FU group and least was in TAC + SGS group. At the end of 4 weeks, excellent improvement was found highest in 29.6% of TAC+5FU group, 22.2% in TAC alone, 18.5% in RF group and 11.1% in TAC+SGS group. At the end of 8 weeks, excellent improvement was found highest in 51.8% of TAC+5FU group, 44.4% in TAC alone, 40.7% RF group and 25.9% in TAC+SGS group. The difference was statistically significant.Skin atrophy, telangiectasia, hypopigmentation and recurrence were observed more TAC group therapies whereas, ulceration and infection were more frequent with RF treatment, however few cases were also seen TAC+5FU group.In this study in terms of pliability and overall improvement maximum response was seen in group TAC + 5 FU and TAC + SGS was least effective.

100 Long Term Outcomes for Inpatient Visits in Bcqp - Feasibility to Bridge the Gap

Abstract Introduction The ABA burn registry is designed to improve the quality and cost of burn care by collecting and exchanging information on burn injuries and outcomes. The BCQP has data related to inpatients visits only. Data on long term outcomes from outpatient settings are not yet available in the ABA’s Quality Burn Registry, but there is agreement that such data should be collected. With any expansion of the registry, attention should be given to the type of data that are collected and the efforts needed to gather accurate data. A pilot phase (alpha pilot) is required before embarking on a larger scale of data gathering. Aim This alpha pilot aims to determine what outcomes should be selected to continue data collection for patients who were discharged from a burn center and are followed up within outpatient settings. Methods The QBR Outpatient Work Group identified 9 items (5 clinical and 4 psychosocial outcomes) that could define the long term outcomes after discharge from the initial admission related to the thermal injuries. A five questions survey was developed to evaluate the length of time spent by registrars to gather the data, and around data quality assurance. Seven verified burn centres were enrolled on voluntary basis on the alpha pilot. Each centre had to enter a patient in each of the predefined categories (age and burn extent related) for the 12 months post discharge divided in 3 monthly periods. The data gathering finished in April 2022. Results A total of 29 patients were entered in the alpha pilot, with 5 patients &amp;lt; 18 yrs of age and 6 over the age 65. The most frequent cause of burn injury was flame (18/29). Fourteen patients sustained burn injuries &amp;gt;20% TBSA. The 95% wound closure was documented in 79.3% and follow up was complete or ongoing for 89.7%. Details about any surgical procedures after discharge was well documented (100%). The burn scar appearance was present in the chart in 69.2% of the cases and only in 3 patients pressure garments was not documented. Presence of depression or PTSD was not documented in 50% of the cases, whereas the presence of pain and itch was documented between 79% to 83%. Registrars found that it took up to 20 minutes to retrieve the data from the charts. Conclusions The findings were presented to the Quality and Burn Registry Committee. As alpha pilot was the first PDSA cycle for this project, further amendments were made to the definitions and layout of the data. A beta pilot (14 hospitals) is ongoing currently as second PDSA cycle in order to identify further barriers for large scale implementation of long term outcomes in the burn registry. Applicability of Research to Practice implementation of long term outcomes in the ABA Burn Registry

A Self-Pumping Composite Dressing Improved Hypertrophic Scar Healing with Dual Therapy and Active-Fluid Transport

Silicone gel sheeting (SGS) and pressure garment therapy (PGT) are the International Clinical Recommendations on Scar Management’s (ICRSM) two principal non-invasive scar-healing procedures. This study created a new PGT-SGS composite (PGF-Biopor®AB-based) via pre-strained screen printing. The Biopor®AB hydrophobicity and nylon-hydrophilicity enabled self-pumping for PGT-SGS dual therapy and pressure-driven “warp insertions” mobility facilitates active-fluid transportation. Integrating both therapies in a single PGT-SGS composite achieved efficacy optimization, and the 3D channel structure allowed trauma-free active-fluid transport. The 3D channel topology enables smooth diffusional transport in active-fluid transport environments—and active “nylon absorbency” improved water uptake and enhanced permeability capabilities with sustainability achieved dynamic hydration. The sole use of PGF-Biopor®AB composite in empirical trials verified dual therapy with trauma-free active-fluid transport with one-month efficacy, providing a new route for dual treatment and active scar management.

Development of a comfort suit-type soft-wearable robot with flexible artificial muscles for walking assistance

Anchoring components are added to wearable robots to ensure a stable interaction between the suits and the human body and to minimize the displacement of the suits. However, these components can apply pressure to the body and can cause user dissatisfaction, which can decrease willingness to use the suits. Therefore, this study aims to develop a suit-type soft-wearable robot platform for walking assistance by providing comfortable garment pressure to ensure user satisfaction. The first prototype of a wearable robot suit was developed with anchoring components on the shoulders, waist, and thighs based on previous research results. Wear tests were conducted to measure garment pressure depending on posture using pressure sensors, and satisfaction surveys were conducted. The second prototype design was then developed, and performance tests with flexible artificial muscles and a satisfaction survey were conducted. Regarding the first prototype, the participants felt more than normal pressure in the shoulders and relatively less pressure in the thighs and calves. Thus, compared to the first design, the second design ensured a decreased garment pressure and resulted in an improvement of overall user satisfaction. These results can help provide guidance in the development of wearable robots by taking pressure comfort and user satisfaction into consideration.

Becoming Experts in Their Own Treatment: Child and Caregiver Engagement With Burn Scar Treatments.

Children who experience a severe burn injury not only require acute medical care but may also need ongoing rehabilitation. To mitigate the potential long-term consequences of scarring and the impact of scarring on their everyday lives, children may be expected to use a variety of time-consuming and multi-component non-invasive scar treatments (such as pressure garments and silicone gels). These treatments may pose unique challenges for children and their caregivers. With limited research previously addressing how Australian children navigate the use of scar treatments at home, this study aimed to develop a grounded theory of children and their caregivers' engagement with non-invasive burn scar treatments. Using a constructivist grounded theory approach, interviews were completed with 20 caregivers and 7 children, and a theory of children and their caregivers becoming experts in the use of non-invasive burn scar treatments was developed. Through persistence and flexibility, they continued to develop expertise. Engaging with scar treatments was an evolving process over time for children with burns and their caregivers. Theoretical categories identified included 'making it work', 'finding the balance' and 'seeking reassurance' and highlighted the remarkable strengths and adaptability of children and their caregivers. Through trial and error, children and their caregivers developed their own unique strategies for engaging with scar treatments. These insightful results may inform the development of interventions to support children and their caregivers' day-to-day engagement with non-invasive burn scar treatments and guide health professionals recommending these treatments.

Safety and adherence of pressure garment therapy in children with upper limb unilateral cerebral palsy. Results from a randomized clinical trial ancillary analysis.

This study was conducted to assess the safety and adherence of the use of a PGT (Pressure Garment Therapy) Lycra® sleeve to treat upper limb unilateral cerebral palsy (UCP) in children. This study was conducted as a prospective, placebo-controlled, double-blinded, randomized monocenter study. Included in the study were 58 UCP children, 49 of whom were analyzed. 25 children (mean age 6.6 ± 1.6 years; 12 girls) were allocated to the active group vs. 24 (mean age 6.7 ± 1.6 years; 10 girls) in the placebo group. The intervention consisted of an active PGT Lycra® arm sleeve manufactured to generate a homogeneous pressure ranging from 15 to 25 mmHg. The placebo PGT Lycra® sleeve was manufactured to generate a homogeneous pressure under 7 mmHg. The time of wearing period was set at 3 h/day at minimum and 6 h/day at maximum, over the course of 6 months. The main outcome measures were safety outcomes including the number and intensity of Adverse Events of Special Interest (AESIs). AESIs were defined as adverse events imputable to compressive therapy and Lycra® wearing. Level of adherence was expressed in percentage of number of days when the sleeve was worn for at least 3 h per day compared to length of duration in days (start and end date of wearing period). Frequency of AESIs were very low and no different between groups (4.12 ± 11.32% vs. 1.83 ± 3.38%; p = 0.504). There were no differences in adherence (91.86 ± 13.86% vs. 94.30 ± 9.95%; p = 0.425). The use of PGT Lycra® arm sleeve in children with UCP is safe and well-tolerated with a very good adherence. The low rate of AESIs is promising for further randomized clinical trials on efficacy.

A Study on Evaluation of Before and After Wearing the Deep Touch Pressure Therapy Compression Garment by Children with Autism

Autism is a neurodevelopmental disorder characterised by severe difficulties in communication and social interaction as well as a restricted pattern of repetitive and stereotyped behaviour. Due to its extensive range of symptoms, including issues with communication and social interaction, repetitive behaviours, and sensory processing disorder, it is known as autism spectrum disorder (ASD). Children with ASD experience anxiety which leads to outbursts and eventual meltdowns. Autism interventions typically involve Deep Touch Pressure (DTP) Therapy. Occupational therapists frequently apply deep pressure to patients with autism spectrum disorders. For children with autism, occupational therapists employ a variety of devices to provide deep contact pressure, including weighted vests, compression vests, pneumatic pressure garments, and weighted blankets etc. Research examining deep pressure is scarce. Additionally, a number of studies have shown the efficacy of DTP. A therapy compression garment for autistic children with sensory defensiveness was developed using a user-centric design paradigm. The aim of this study was to evaluate the before and after wearing the deep touch pressure therapy compression garment worn by the six wearer children with Autism.

Effects and mechanism of pressure treatment on hemodynamic changes in patients with hypertrophic scar secondary to extensive burns

Objective: To investigate the hemodynamic changes of the main arteries and veins of the extremities and the heart in patients with hypertrophic scar secondary to extensive burns after pressure treatment, and to analyze the relevant mechanisms. Methods: A retrospective before-after self-control study was conducted. From January 2017 to February 2022, 37 patients with hypertrophic scar secondary to extensive burns who met the inclusion criteria were hospitalized in the Burn Rehabilitation Department of Guangdong Industrial Injury Rehabilitation Hospital, including 25 males and 12 females, aged 23-52 years. The patients were admitted to the hospital within 12 weeks after wound healing, and within one week after admission, rehabilitation therapists, occupational therapists, and tailors custom-made pressure products such as full-body pressure garment, pressure pants, vests, split finger gloves, split finger socks, hoods, and plastic collars, with the pressure at each part maintained at 2.67-4.00 kPa when wearing. Before the first treatment with pressure products (hereinafter referred to as before pressure treatment) and at 1 h of the first treatment with pressure products (hereinafter referred to as 1 h of pressure treatment), color Doppler ultrasonography was performed to check the pulse rate of the axillary artery, the lumen diameter, peak systolic velocity (PSV), and resistance index of the axillary artery and femoral artery on the left side, the lumen diameter, cross-sectional area, and average blood flow velocity of the axillary vein and femoral vein, and the mitral valve E peak, mitral valve A peak, tricuspid valve E peak, aortic valve PSV, and pulmonary valve PSV of the heart; an optical chromatographic skin detector was used to detect the red color, red pigment, and surface brightness of the scar on the back of the hand to reflect the filling and distribution of the scar microvessels. Data were statistically analyzed with paired sample t test. Results: Compared with those before pressure treatment, the PSV of the axillary artery of patients was significantly slowed down at 1 h of pressure treatment (t=55.42, P<0.01); the average blood flow velocity of the axillary vein was significantly accelerated (t=-60.50, P<0.01); the pulse rate, lumen diameter, and resistance index of the axillary artery, as well as the lumen diameter and cross-sectional area of the axillary vein did not change obviously (P>0.05); the average blood flow velocity of the femoral vein was significantly accelerated (t=-80.52, P<0.01); the lumen diameter, PSV, and resistance index of the femoral artery, as well as the lumen diameter and cross-sectional area of the femoral vein had no significant change (P>0.05); the mitral valve E peak and mitral valve A peak of the heart decreased significantly (with t values of 10.71 and 21.96, respectively, P<0.01); the tricuspid valve E peak of the heart increased significantly (t=7.57, P<0.01); the PSV of the aortic valve and pulmonary valve of the heart did not change obviously (P>0.05). At 1 h of pressure treatment, the red color and red pigment values of the scar on the back of the hand of patients were 15.3±1.1 and 16.8±1.2, respectively, which were significantly lower than 24.5±1.3 and 23.8±1.2 before pressure treatment (with t values of 8.32 and 8.04, respectively, P<0.01). The brightness value of the scar surface on the back of the hand of patients at 1 h of pressure treatment was similar to that before pressure treatment (P>0.05). Conclusions: After pressure treatment for the hypertrophic scar in patients secondary to extensive burn, the average blood flow velocity of the axillary vein and femoral vein in patients are obviously accelerated, the PSV of the axillary artery is significantly slowed down, the peak values of mitral valve E and mitral valve A of the heart are significantly decreased, and the tricuspid valve E peak is significantly increased. These hemodynamic changes may be related to the reduction of microvascular blood flow in the local area of scar after systemic pressure treatment.

A review of occupational therapy services within an acute public tertiary hospital in KwaZulu-Natal, South Africa

INTRODUCTION: The provision of occupational therapy services in providing a minimum essential service in public health institutions in South Africa are currently guided by a quality control measure by the National Department of Health. AIM: To review the occupational therapy services in an acute, public tertiary hospital from 2015-2019 and to compare this with the expectations of these services in a tertiary hospital to identify potential gaps in service delivery. METHOD: A single site, retrospective quantitative audit from 2015-2019 was completed at one tertiary hospital. Patient-related and occupational therapy service data were included. 18579 patient entries were captured. The analysis included descriptive and inferential statistics of mean, standard deviations, frequency tables, percentages, and ANOVA. RESULTS: Findings indicated a consistent decline in the mean values of, the number of therapists attending to patients, number of patients, assistive devices issued, total time of patient units and consultations, total time spent on ward rounds, clinics, and meeting attendance. The number of student therapists attending to patients, splints, pressure garments and issued wheelchairs showed an increase in trend across the reviewed years. CONCLUSION: Inadequate human resources and budget systems are potential gaps in occupational therapy service delivery in an acute public tertiary hospital.