Pressure Garments Research Articles

Augmented robotic device for EVA hand manoeuvres

During extravehicular activities (EVAs), pressurised space suits can lead to difficulties in performing hand manoeuvres and fatigue. This is often the cause of EVAs being terminated early, or taking longer to complete. Assistive robotic gloves can be used to augment the natural motion of a human hand, meaning work can be carried out more efficiently with less stress to the astronaut. Lightweight and low profile solutions must be found in order for the assistive robotic glove to be easily integrated with a space suit pressure garment. Pneumatic muscle actuators combined with force sensors are one such solution. These actuators are extremely light, yet can output high forces using pressurised gases as the actuation drive. Their movement is omnidirectional, so when combined with a flexible exoskeleton that itself provides a degree of freedom of movement, individual fingers can be controlled during flexion and extension. This setup allows actuators and other hardware to be stored remotely on the user's body, resulting in the least possible mass being supported by the hand. Two prototype gloves have been developed at the University of Sydney; prototype I using a fibreglass exoskeleton to provide flexion force, and prototype II using torsion springs to achieve the same result. The gloves have been designed to increase the ease of human movements, rather than to add unnatural ability to the hand. A state space control algorithm has been developed to ensure that human initiated movements are recognised, and calibration methods have been implemented to accommodate the different characteristics of each wearer's hands. For this calibration technique, it was necessary to take into account the natural tremors of the human hand which may have otherwise initiated unexpected control signals. Prototype I was able to actuate the user's hand in 1 degree of freedom (DOF) from full flexion to partial extension, and prototype II actuated a user's finger in 2 DOF with forces achieved comparable to those of a natural, healthy hand. The minimum mass held by the user on the hand was 240g, with remote hardware, including a compressed air bottle, having a further mass of 1.6kg. These results indicate that the design is able to augment human motion in a low profile, low mass package, and could be a valuable addition to a space suit during an EVA.

The Change of Garment Pressure and Body Measurement by Material of Women's Girdle

Objective: The aim of this study was to investigate the appropriate elasticity of the textile material used for making women"s girdle. Background: The elastic textiles have been used for making girdle. The hard type girdle gave high pressure on the body to make slim look. However, excessively high garment pressure caused negative effect to human bodies. This study studied the material giving proper garment pressure in girdle. Method: In this study five experimental girdles were made fabrics with various elasticities. The change of garment pressures and body girths were measured after subjects wearing the experimental girdles. The garment pressure was measured at 10 points. Body girths measured at abdomen, hip, and thigh. Results: The garment pressure of the commercial girdle was high at side of waistband, side femur and back gluteal fold.The experimental girdles made with high elasticity material definitely lowered garment pressure at those points. After wearing experimental girdle their abdomen and hip girths measurements were decreased. But, thigh girth was not reduced. Conclusion: The girdle made with excellent elasticity materials reduced garment pressure significantly and it made body slim as much as the commercial girdle except the thighs. Application: This study provides guideline for the developing girdle that applying optimum range of garment pressure with body slim effect.<BR><BR><BR><BR><BR><BR><BR>

슬랙스 맞음새 평가 도구 설계에 관한 연구

In this study, fitness tests for slacks were divided into shape fitness test and motion fitness test, and the fitness test conditions for slacks were designed as the first step for standardization of measuring scales. Shape fitness test consisted of analyzing the parameters of appearance sensory tests as described in preceding studies, performing a simulated appearance sensory test, collecting and considering apparel experts' opinions about the test parameters, and establishing test conditions in terms of test regions, descriptions and faces. For the regions of the abdomen, hip, crotch, thighs, and knees, the parameter of unnecessary wrinkle/stretch was observed from the anterior and posterior body, and then evaluated; for waist, hip, crotch, knee and hem circumference, the parameters of ease and horizontality were observed from the anterior body and posterior body followed by evaluation; and, at the levels of waist, hip, crotch, knee and hem circumference, the division of the lateral line were observed from the lateral body followed by evaluation. Motion fitness test was composed of reviewing and analyzing comparatively the methods of motion fitness tests as mentioned in preceding studies, and establishing test conditions in terms of test motions and test regions. For each of the waist, abdomen, hip, crotch, and knees, wear sensation was tested in the positions as follows: upright standing, moderate walking, chairsitting, bending forward to the maximum, and kneeling down, provided that as the measured points of garment pressure, anterior waist, abdominal protrusion, buttock protrusion, crotch, and midpatella were set and tested.

스키니 진 착용이 인체생리반응과 주관적 압박감에 미치는 영향

The purpose of this study was to analyze and determine the relationship between physiological responses including blood flow rate and garment pressure, and the feeling of restrictive tightness associated with the wearing skinny pants as a popular clothing style. Evaluation was based on material type, posture and activity type, and body part location. Five female college students took part in this research. Five kinds of experimental clothes with waist measurements of 66cm were chosen. An analysis of the selected skinny pants demonstrated the degree of the whole looseness was higher in this order: clothing type A>B>D>C, and E with E being knitted cloth. Garment pressure was the highest in the front knee portions and was lowest in the outside thigh region. Garment pressure was highest in this sequence : clothing type C>=D>A>=B>E. In terms of posture and activity types, garment pressure was the highest when research participants were crouching, and was the lowest when standing. The blood flow rate was highest in this order: clothing type E>D>B>A>C. Type C skinny pants impeded blood flow and demonstrated the tightest and most restrictive relationship. Blood flow rate varied depending on the type of movement and was highest in this order: getting up, rowing, kicking, jumping and O-shaped leg posture. The results of subjective pressure evaluation demonstrated that pressure was highest in this order: E>=C>B>A>D. These results suggests the need to improve on the patterns and the material design in the area of the front knees. The degree of the looseness when wearing skinny pants did not always correspond to garment pressure or subjective sensation.

Development of a Pressure-Measuring Device to Optimize Compression Treatment of Lymphedema and Evaluation of Change in Garment Pressure with Simulated Wear and Tear

The use of compression garments in treating lymphedema following treatment of genital (penis, testes, uterus, cervical) and breast cancer treatment is a well-established practice. Although compression garments are classified in compression classes, little is known about the actual subgarment pressure exerted along the extremity. The aims of this study were to establish an in vitro method for measuring subgarment pressure along the extremity and to analyze initial and over time subgarment pressure of compression garments from three manufacturers. The measurements were performed with I-scan(®) (Tekscan Inc.) pressure measuring equipment once a week during a period of 4 weeks. Wear and tear was simulated by washing and putting on the garments on plastic legs every day. There was a statistically significant difference between the garments of some of manufacturers. There was no difference between garments from the same manufacturer. No significant decrease of subgarment pressure was observed during the trial period. The study demonstrated that Tekscan pressure-measuring equipment could measure subgarment pressure in vitro. The results may indicate that there was a difference in subgarment pressure exerted by garments from different manufacturers and that there was no clear decrease in subgarment pressure during the first four weeks of usage.

Surgical treatment of a Morel-Lavallée lesion of the distal thigh with the use of lymphatic mapping and fibrin sealant

A Morel-Lavallée lesion can occur after a closed degloving injury. It is a persistent seroma that may be resistant to conservative methods of treatment such as percutaneous drainage and compression therapy. We present a novel, successful method of surgical treatment. A 70 year-old lady developed a 30 × 15 cm rapidly enlarging right medial thigh/knee swelling after being hit by a car. Conservative treatments failed, sarcoma was excluded, and the diagnosis confirmed, by MR imaging and cytology prior to referral. The lesion was excised, and blue dye lymphatic mapping used to identify and ligate feeding lymphatic vessels. The cavity was then closed using fibrin sealant spray and resorbable quilting sutures. A pressure garment was fitted. The wound healed without complication, with no recurrence at six months. The patient returned to normal activities without pressure garments. This method provides a novel, successful approach to the surgical treatment of a chronic Morel-Lavallée lesion.

3차원 스캔 기술과 니트 소재의 신축성을 적용한 밀착형 스포츠웨어 상의 설계

This research studied how to develop tight upper sportswear from 3D scan data considering fabric stretch property. Subjects were five Korean men of average figure in their 20's. Scanning was done for ten postures via vitus smart/pro(Techmath LTD). Analyzing from 3D scan data, more than 70% of the upper body surface showed surface change rate under 20%. It was shoulder and under arm side part that showed most noticeable body surface change when moving. A parametric model with convex surface was generated and flattened onto the plane, resulting 2D pattern. The error rate occurring in the process of 3D to 2D conversion was 0.2% for outline and 0.13% for area, respectively. Thirteen kinds of stretchable fabrics in the market were collected for this study. Stretch property was in the range of 16.0~58.2% for wale direction; 23.1~78.4% for course. Based on wear trial test, four fabrics were chosen for making the 1st experimental garment and finally one fabric was chosen for the 2nd one, which was developed applying 4 kinds of crosswise reduction rate on 2D pattern: 0, 5, 10, and 15%. Through wear trial test and garment pressure measurement, experimental garment applied with 10% pattern reduction rate was evaluated as most comfortable and considerable.

Issues to address in burn care for ethnic minority children: A qualitative study of the experiences of health care staff

IntroductionNumerous studies have shown that ethnic minority children in the developed world are at greater risk of sustaining burns compared to children from non-ethnic minority backgrounds. However, little is known about the experiences of hospital health care staff with ethnic minority children and parents. A qualitative interview study was conducted to gain more insight into burn care for ethnic minority children and the potential challenges this presents. MethodsSemi-structured interviews on burn care for ethnic minority children were conducted in 2009 with health care staff (N=17) working in two burn centers in the Netherlands. Interviews were transcribed and analyzed using a framework method. ResultsHealth care staff identified the following issues in burn care for ethnic minority children and their parents: (1) linguistic barriers to communication with parents about pressure garments, dressing changes, skin grafting procedures, and psychosocial support; (2) biological/genetic features of differing pigmentation of skin and skin healing; (3) cultural differences between parents and health care staff; (4) insecurity or irritation about linguistic and cultural barriers. ConclusionsBurn health care staff should have knowledge of biological/genetic features of dark skin, awareness of cultural differences, and transcultural communication skills to deliver culturally competent care tailored to the needs of ethnic minority children and their parents.

Pulsed dye laser treatment with different onset times for new surgical scars: a single-blind randomized controlled trial

In humans, regeneration of wounds is limited and the wound repair process leads to a nonfunctioning mass of fibrotic tissue known as a scar, which can be more or less visible [1]. The final appearance of a surgical incision is an important concern for patients and physicians. Scarring can cause discomfort and psychological stress for patients. Surgical scars can be flat, hypertrophic or atrophic. The etiology and mechanism of scarring are not fully understood. Scars are thought to be difficult to treat and almost impossible to prevent. Several nonsurgical (pressure garments, topical and systemic corticosteroids, silicone gel sheeting, 5-fluorouracil, radiotherapy, interferon, bleomycin, topical retinoic acid, colchicine, D-penicillamine) and surgical interventions (laser, cryosurgery, skin grafting, scar revision, dermatography) have been investigated for the treatment of scars [2–6]. Laser treatment may provide an alternative to the long list of current treatment options. Different laser systems have been used to prevent or treat scars. The argon laser was introduced in 1978 [7]. Abergel et al. showed the effectiveness of the 1,064 nm Nd:YAG laser in the treatment of scars [8]. Castro et al. [9] found that the effect of the Nd:YAG laser (at an energy level of 1.7×10 J/cm) could be due to selective inhibition of collagen production with no effect on DNA synthesis or cell viability. The diode laser has also been used for the treatment of scars. A preliminary study has suggested that treatment with the diode at 810 nm in the early phases can change the physiology of wound healing significantly, and thus prevent scar formation [10]. In 1993, Alster reported that the flashlamp pulsed dye laser (PDL) at 585 nm significantly improves erythematous and hypertrophic scars [11]. PDL is currently the laser of choice for the treatment of scars. The exact mechanism by which PDL exerts antiscarring effect remains unclear. The majority of the lasers including PDL emit light energy that is absorbed by hemoglobin, generating heat and resulting in damage to the microvasculature [12]. It has been reported that the 585-nm PDL can decrease fibroblast proliferation and collagen type III deposition [13]. McCraw et al. were the first to describe the use of laser therapy of postsurgical scars. In an uncontrolled study they found that early laser therapy was safe and effective [14]. Nouri et al. in a controlled study found that the 585-nm PDL on the day of suture removal is effective and safe in the treatment of fresh surgical scars [15]. This finding was confirmed again in another study using a cryogen-cooled 595-nm PDL laser [16]. On the other hand it seems that one single pass of the PDL on the day of suture removal does not improve the appearance of surgical scars and more than one pass is recommended [17]. In a trial comparing the 585-nm with the 595-nm PDL, Nouri et al. found that 585 nm was the preferred wavelength, as it markedly normalized the height, vascularity and elasticity of scars [18]. Additionally, Nouri et al. reported that both shortand long-pulse PDL started on the day of suture removal effectively and safely improve the quality and cosmetic appearance of surgical scars [19]. Although laser treatment on the day of suture Clinical trial registration number: NCT00506363 P. Davari : F. Gorouhi : P. Hashemi : F. Behnia : M. Nasiri-Kashani :A. Firooz (*) Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, 415 Taleghani Ave, Tehran 14166, Iran e-mail: firozali@sina.tums.ac.ir

Release of the Postburn Contractures on the Lower Abdomen and Inguinal Regions Using Modified Abdominoplasty

To return the patient to normal function while maximizing aesthetic appearance is the most important issue in burn management. Although many techniques such as pressure garments and silicone dressings are used in the initial scar management to optimize final appearance, avoiding residual scarring is impossible after extensive burns. The changes in appearance and limitations imposed by the burn scar contribute to a negative body image. Burn patients frequently require numerous procedures over many years to achieve optimum function, but aesthetic needs are often overlooked in these patients. By assessing such patients with regard to their body image and aesthetic needs, patients who will benefit from a combined aesthetic procedure with burn contracture release are easily identified. The author presents a female patient who underwent modified abdominoplasty for releasing burn scar contractures, providing the dual benefit of improved body contour and burn scar release.

Seroma Formation after Breast Cancer Surgery: What We Have Learned in the Last Two Decades

Formation of a seroma most frequently occurs after mastectomy and axillary surgery. Prolonged drainage is troublesome as it increases the risk for infection and can significantly delay adjuvant therapy. Seroma has been defined as serous fluid collection under the skin flaps or in the axillary dead space following mastectomy and/or axillary dissection. Because the true etiology of a seroma is unknown, a multifactorial-causation hypothesis has been accepted. Surgical factors include technique, extent of dissection and the surgical devices used for dissection. Obliteration of dead space with various flap fixation techniques, use of sclerosants, fibrin glue and sealants, octreotide, and pressure garments have been attempted with conflicting results and none have been consistent. Early movement of the shoulder during the postoperative period may increase the formation of seroma, although delayed physiotherapy decreases the formation of seroma. A detailed analysis of the use of drains showed that use of single or multiple drains, early or late removal, and drains with or without suction are not significantly different for the incidence of seroma. Although there is evidence for reduced seroma formation after early drain removal, very early removal within 24 hours seems to increase formation of seroma. No patient or tumor factors seem to affect seroma formation except body mass index and body weight. Consensus is lacking among studies/trials with different groups producing conflicting evidence. Besides a few established factors such as body mass index, the use of electrocautery for dissection, early drain removal, low vacuum drains, obliteration of dead space, and delayed shoulder physiotherapy, most of the hypothesized causes have not been demonstrated consistently. Thus, seroma remains a threat to both the patient and surgeon. Recurrent transcutaneous aspiration remains the only successful management.

Development of medical garments and apparel for the elderly and the disabled

The paper critically reviews medical garments with various functions and development aspects. Textiles used and developing technologies are systematically introduced. Medical garment products are described according to three major functions: protective, treatment and caring functions. Although the main theme of this paper discusses products for the elderly and the disabled, it also contains major parts on medical garments, which include personal protective equipment (PPE), hip protectors (HP), pressure garments (PG), compression stockings (CS), wet dressings, products for wound dressing, adult incontinence products, sanitary napkins, disposable diapers, vital signs monitoring garments, motion aware clothing, wearable sensors and smart diapers and so on. The development of apparel for the elderly and the disabled is a challenge for the healthcare and clothing industries. The developed apparel products are not only based on various design, fashion and comfort concepts but also considered in terms of particular medical problems, restorative care functions and appropriate solutions for healthcare purposes.

Burn management

To update critical care practitioners on the recent advancements in burn care. Particular topics discussed include airway management, acute resuscitation, issues within the intensive care unit, nutrition, and wound management. This is a concise review of the recent burn literature tailored to the critical care practitioner. Criteria for extubation of burn patients are examined, as is the need for cuffed endotracheal tubes in pediatric burn patients. Strategies to avoid over-resuscitation are discussed, including use of colloid, as well as nurse-driven and computer-guided resuscitation protocols. New data regarding common ICU issues such as insulin therapy, delirium, and preferred intravenous access are reviewed. The importance of nutrition in the burn patient is emphasized, particularly early initiation of enteral nutrition, continuation of nutrition during surgical procedures, and use of adjuncts such as immunonutrition and beta blockade. Finally, both short-term and long-term wound issues are addressed via sections on laser Doppler assessment of burns and pressure garment therapy to prevent long-term scarring.

Customised Pressure Garment Development by Using 3D Scanned Body Image

The objective of this research is to develop a method for designing customised pressure garments that can be more accurately applied to a burn wound area. The method includes the use of a 3D digital image of the wounded body part obtained by a body scanner and the development of a 3D pressure garment model and a 2D pattern. The scanned data contain detailed information that cannot be feasibly obtained by manual measurements, such as body curvature. The model parameters include the pressure to be exerted, pressure garment fabric properties and radius of curvature of the cross-sections of scanned body parts. By using a 3D pressure garment model, a 2D garment pattern is developed, and then, a pressure garment is constructed by using the pattern. The technique has been experimentally verified and customised pressure garments are made for a number of volunteer subjects. The customised pressure garments made for the subjects exert pressures close to the design pressure, but vary along the circumference of a given cross-section. The customised pressure garments constructed by using the developed method have shown a more accurate fit to uniformly exert the design pressure onto the whole of the wounded area.

Effect of input tension of inlay yarn on the characteristics of knitted circular stretch fabrics and pressure generation

Stretch fabrics are used in manufacturing pressure garments to exert pressure over specific body parts in medical conditions like venous and lymphatic disorders, scar management, and bone and muscle injuries. The amount of therapeutic pressure required in each medical condition is different; therefore, there is a need to engineer the stretch properties of garments to match the requirements in each case. Limited information is available on the relationship between fabric properties and the pressure generated on the body. In this paper, an attempt has been made to study the effect of inlay yarn pre-tension at the time of manufacturing of stretch fabrics on the pressure generated by the garments. Results show that change in inlay pre-tension significantly changes the structural characteristics of the fabric but the load elongation behavior remains unchanged up to 100% extension. Pressure exerted on rigid cylindrical tubes increases with reduction factor of the fabric tube and the curvature of the cylinder.

Pressure Garment Therapy Alone and in Combination with Silicone for the Prevention of Hypertrophic Scarring

Published trials evaluating pressure garment and/or silicone therapy as a treatment for hypertrophic burn scarring are of poor quality and highly susceptible to bias. The authors' aim was to compare the efficacy of pressure garment therapy alone and in combination with silicone gel sheet or spray therapy for the prevention of hypertrophic scarring. The authors conducted an open, single-center, randomized controlled study with intraindividual comparison of study preparations and control to standard treatment. Forty-three consecutive patients with two comparable areas of split-thickness graft burn wounds were recruited into the study, and 38 patients were followed up for 18 months. All patients received compression garments and were randomized to one of two treatment groups: (1) self-drying silicone spray and compression versus compression alone and (2) silicone sheeting and compression versus compression alone. Clinical assessment, measurement of scar redness, height, and photographic documentation of each treated area were performed at different visits over an 18-month follow-up period. Significance was tested using repeated-measures analyses and Wilcoxon paired-sample signed rank tests. Use of pressure garment therapy alone produced results equivalent to those of combined silicone and pressure garment therapy in the prevention of hypertrophic scars. The efficacy of silicone spray therapy was comparable to that of silicone gel sheet therapy in the prevention of hypertrophic scars. Patients treated with silicone spray had fewer side effects when compared with the silicone sheet group. Multimodal therapy with silicone and pressure garment therapy failed to prevent hypertrophic scars beyond that observed with pressure garment therapy alone. Therapeutic, II.

New calibration method for I-scan sensors to enable the precise measurement of pressures delivered by ‘pressure garments’

Accurate measurement of the pressure delivered by medical compression products is highly desirable both in monitoring treatment and in developing new pressure inducing garments or products. There are several complications in measuring pressure at the garment/body interface and at present no ideal pressure measurement tool exists for this purpose. This paper summarises a thorough evaluation of the accuracy and reproducibility of measurements taken following both of Tekscan Inc.’s recommended calibration procedures for I-scan sensors; and presents an improved method for calibrating and using I-scan pressure sensors. The proposed calibration method enables accurate (±2.1 mmHg) measurement of pressures delivered by pressure garments to body parts with a circumference ≥30 cm. This method is too cumbersome for routine clinical use but is very useful, accurate and reproducible for product development or clinical evaluation purposes.

More Than Good Intentions: Advancing Adherence to Therapy Recommendations

More Than Good Intentions: Advancing Adherence to Therapy Recommendations

The Stepwise Regression Model between Munsell Color Index and Clothing Pressure of Knitted Tight-Fit Sports Pants

Through testing the Munsell color index and the static fabric pressure of the tight pants, the paper has established eight related model with the method of the stepwise regression analysis. The result shows that (a) The static garment pressure of the stretch knitted pants can be predicted with stepwise regression models which are using the Munsell color index and fabric specifications as input parameters, and prediction models have the high adjusted correlation coefficients, and have smaller errors between predicted values and measured values. (b) The static garment pressure of the stretch knitted pants has some relationship with dynamic surface wetness of fabrics. (c)The relationship between the static garment pressure of the stretch knitted pants and the weft density is not obvious.

Lymphedema

Lymphedema therapy has gone by many names in the recent past, being referred to as complex decongestive therapy, complex physical therapy, or decongestive lymphatic therapy, among others. There are two phases of lymphedema treatment: the acute "intensive" phase and the maintenance phase. In the acute phase of treatment, the individual is typically wrapped with medical short-stretch compression bandages; receives a therapeutic exercise routine, skin care, and education; and undergoes manual lymphatic drainage by a specially trained physical therapist or healthcare professional. In the maintenance phase, the goals are for the individual to be able to wear a well-fitted appropriate gradient pressure garment during the day and compression bandaging (or a device that serves as an alternative to bandaging) at night, to maintain good skin care, to continue with therapeutic exercise, and to self-perform manual lymphatic drainage (or use a mechanical device that can perform manual lymphatic drainage) for the area of the body with impaired lymphatics. The effectiveness of the various components in each phase, as well as the motivation and compliance of the patient, differs. Further randomized trials are required to determine which component or combination of components in complex decongestive therapy works most effectively. It is recommended for patients not only to maintain physical activity for its many health benefits but also to facilitate muscle pumping to move lymphatic fluid throughout the body. Knowledge of some of the pathophysiologic mechanisms involved in the development of lymphedema is increasing, and it is possible that current modes of treatment of lymphedema will be augmented by molecular therapies in the future.