Compression Bandages ; Cysts ; surgery ; Humans ; Sutures

OBJECTIVETo investigate the mechanisms of pressure intervention, and to explore the most effective regime for pressure therapy.

METHODSSeveral trials were carried out to study the efficacy and mechanism of pressure therapy, and the development and application efficacy of a smart pressure monitored suit (SPMS) for scar management. (1) Effectiveness of pressure therapy. Forty-five patients suffered burn on extremities were divided into pressure treatment group (n = 36) and control group (n = 9) according to the random number table. Patients in pressure treatment group were prescribed with a regime of wearing custom pressure garment (10% strain rate of pressure + 9 mm thick local pressure padding) more than 23 hours per day, while no active intervention was conducted on patients in control group. Scar conditions were assessed using the Vancouver Scar Scale (VSS), spectrocolorimeter, and tissue palpation ultrasound system. Data were processed with t test or paired t test. (2) Changes in fibroblasts growth rate under pressure. Fibroblasts extracted from scar tissue excised during surgery were loaded with 0, 1.1, 2.8, 5.6 mm Hg (1 mm Hg = 0.133 kPa) pressure respectively to observe the growth rate of fibroblasts. Data were processed with Fisher LSD post-hoc analysis. (3) Scar thickness upon pressure. The changes in scar thickness upon 0, 5, 15, 25, 35 mm Hg pressure were measured at early stage (1 - 6 months), mid-stage (7 - 12 months), and late stage (more than 12 months) using the high frequency ultrasound imaging system. Data were processed with correlation analysis and regression analysis. (4) Study on application of SPMS. Thirty-six patients with hypertrophic scars once treated with the conventional garment were recruited and they were prescribed with the regime of wearing SPMS for one month. Feedback from all participants in rating conventional garment and SPMS was obtained using self-reported questionnaire. The interface pressure of pressure garment was measured using the Pliance X system. Data were processed with Wilcoxon Sign-Ranks test.

RESULTS(1) Scar thickness, color, and VSS score were significantly improved in pressure treatment group after two-month of pressure intervention. VSS score of the scars in pressure treatment group was lower than that in control group two months after treatment. (2) The growth rate of scar fibroblasts under 5.6 mm Hg pressure was obviously lower than that under 0 mm Hg pressure 2 days after pressure loading (mean deviation = 0.086, P = 0.001). Growth rates of fibroblasts under 2.8 and 5.6 mm Hg pressure were obviously lower than that under 0 mm Hg pressure 3 days after pressure loading (with mean deviation respectively 0.060 and 0.118, P = 0.003, P < 0.001). (3) Scar thickness was significantly reduced upon pressure, and a negative relationship between scar thickness and pressure level was observed (r = -0.96, P < 0.01). (4) The results of SPMS study showed a reduction in both static pressure (19.5%) and dynamic pressure (11.9%) after one month of usage; while there was nearly 50.0% reduction in pressure in conventional garment. SPMS was rated significantly higher than conventional garment in terms of comfort, permeability and clinical efficacy (P ≤ 0.001).

CONCLUSIONSPressure therapy can effectively inhibit the growth of hypertrophic scar, while its exact mechanism needs further study for verification. SPMS is convenient to apply for patients. It takes less time to fabricate and adjust when compared to the conventional garment. Its clinical effect is positive and it may expand its application to other medical conditions.

Otohematoma is a fairly common disease in otolaryngologic clinics. Many physicans have been challanged with various method of management on auricular hematoma. The initial treatment usually involves simple aspiration and a compression bandage. But most of these treatments are recurrent problems and eventually become the cauliflower ear. A treatment involves a total excision of the newly formed fibroneocartilaginous layer. If hematoma persists, perichondrium becomes irregular by thickned fibroneocartilage formation. We treated 11 patients with otoplasty to remove fibroneocartilage under local anesthesia. We found that the perichondrium formed severe fibroneocarilage and organization after 2 weeks. We studied the sequence of pathological changes that occurs after injury.
Anesthesia, Local ; Brassica ; Compression Bandages ; Ear ; Hematoma ; Humans ; Larynx ; Pathology

The tie-over dressing is a time consuming work because the long silk sutures get tangled and one must spend time on securing the ends. However it is a necessary procedure for a better take of the skin graft. The skin graft was prepared as a split-thickness graft with or without meshing. After hemostasis of the recipient defect, the prepared skin was placed and tailored for the defect. The skin stapler hold the skin margin, split-thickness graft and a round rubber band in one stitch. And the mesh gauze with ointment was applied over the grafted skin and the bulky moist dressing was applied with fluffy gauze and cotton. Over the bulky dressing the rubber bands crossed over and fixed on the other side of the surrounding edge on the normal skin area by the skin stapler. In case of need, splint and compressive dressing with elastic bandage was applied. From January, 2002 to September, 2002, in 15 patients, this method has been used and proven satisfactory. Skin graft was well taken and the time for tie-over dressing can be reduced markedly. We can ensure the adherence of a skin graft to the bed of the wound by continuous pressure dressing. This technique is simple, fast, and no needs of any special device or dressing materials.
Bandages* ; Compression Bandages ; Hemostasis ; Humans ; Rubber* ; Silk ; Skin* ; Splints ; Sutures ; Transplants ; Wounds and Injuries

PURPOSE: Yearly many children attend hospital with burns. Most of them are injured to face and neck. In palliative ways, dressing with vaseline gauze, it is thick and tight to absorb the exdute and maintain, but patients are inconvinient in eating and speaking. Especially, in pediatric face and neck burn patients, cooperation is impossible, so there is increased risk of secondary infection by wound exposure and physician should make dressing more frequently. In case of using dressing material, it is not far different in palliative dressing, we should use a tape or elastic bandage to keep wound surface and dressing material in contact. Versiva(R) is combination dressing materials of hydrocolloid, hydrofiber, a polyurethane foam. Authors have used Versiva(R) in a treatment of pediatric face and neck burn, and we experienced that maintenance of dressing is convenient and nutrition supply is easy through oral feeding. METHODS: Between from 2006 January until 2008 December, we performed dressings with Versiva(R) in 20 pediatric second degree face and neck burn patients. Until postburn 2 nd or 3 rd day, we exchanged dressing daily, and after this, exchanged in 2~3 days according to amount of exudate. RESULTS: Versiva(R) had enough absorbing capacity and adhesive strength at the same time. With this slight and thin dressing material, there was considerable decrease in discomfort of patient, frequency of secondary infection and keeping dressing were convenient. Oral feeding was easy due to waterproof surface of the Versiva(R). In comparison with effort and time in palliative dressing, there was a significant reduction of labor force. CONCLUSION: In Treatment of pediatric second degree face and neck burn patient, Versiva(R) dressing was effective method because of decreased hospital day, convinience, labor reduction, decreased patient discomfort, easy to oral feeding.
Adhesives ; Bandages ; Burns ; Child ; Coinfection ; Colloids ; Compression Bandages ; Eating ; Exudates and Transudates ; Humans ; Neck ; Petrolatum ; Polyurethanes

Rheumatoid lymphedema (RL) is a rare complication of rheumatoid arthritis (RA). The pathophysiology of RL is not yet fully understood, and the management is also not standardized. As yet, there is low awareness regarding RL and complex decongestive physical therapy (CDPT) among physicians; hence, diagnosis and treatment are delayed. A few studies have reported the positive effects of tumor necrosis factor-α inhibitory drugs on RL. CDPT is still considered the gold standard for the treatment of cancer-related lymphedema, but there are few reports on the effects of CDPT on RL. Therefore, we report two cases of chronic International Society of Lymphology lymphedema stage II RL that exhibited good therapeutic outcomes after CDPT. One of the two patient had taken a tumor necrosis factor-α inhibitory drug, but RL still has progressed. However, CDPT with multilayer bandage showed significant reduction in the pain and edema of the lower extremities.
Arthritis, Rheumatoid ; Bandages ; Compression Bandages ; Diagnosis ; Edema ; Humans ; Lower Extremity ; Lymphedema ; Necrosis

Kasabach-Merritt syndrome is rare disorder which consists of hemangioma and thromobocytopenia occurring in infatns. Two cases of giant hemanioma with thrombocytopenia and anemia are reported with review of literures. It is postulated that the abnormalities resulted from intravascular coagulation within the hemangioma. Those patients were managed with prednisolone administration, blood transfusion and compression with the elastic bandage over the hemangioma. Following the conservative therapy the hemangioma regressed and the platelet and the erythrocyte returned to normal.
Anemia ; Blood Platelets ; Blood Transfusion ; Compression Bandages ; Erythrocytes ; Hemangioma ; Humans ; Kasabach-Merritt Syndrome* ; Prednisolone ; Thrombocytopenia

No abstract available.
Aneurysm, False* ; Blood Pressure Monitors* ; Blood Pressure* ; Compression Bandages* ; Humans ; Radial Artery*

OBJECTIVE: To compared with the modified Robert Jones bandage of 3M elastic bandage, to evaluate the fitness, convenience, safety and comfort of the modular combination lower limb elastic compression device. METHODS: Forty healthy adult college students, including 28 males and 12 females, aged 16 to 25 (20.3±2.2) years old and weighing 40 to 81 (60.4±20.2) kg, were randomly divided into two groups with 40 samples in each group. According to the body surface parameters of Chinese lower limbs and guided by the concept of modularization, a group of modular combined lower limb elastic compression device was designed. Each module was combined to evaluate the fitness of the modular combined compression device in thelength and circumference of the lower limbs. The left and right lower limbs were randomly paired and divided into groups, with 40 samples in each group. The convenience of the operation time, adjustment times and required time were compared between two groups. The safety of the two groups after 24 hours of application of pressure injury was compared. The subjective pain feeling changes within 24 hours were recorded by visual analogue scale (VAS) to evaluate the comfort. RESULTS: The device was composed of several elastic compression outer lining modules with different length and width of 15 cm, an inner lining module for buffering, positioning and attaching the main body, and an elastic ankle compression module. The length of the elastic compression outer lining module covers the circumference of the human lower limbs. The length of a single outer lining module increased from 15 cm to 80 cm every 5 cm interval, and the length of a single inner lining module increased from 62 cm to 83 cm every 3 cm interval. After the modules were selected and combined, the length and circumference of the lower limbs can reach 100% fitness. The operation time of the first placement(118.23±7.33) s and re operation(60.08±5.88) s of experimental group were significantly shorter than those of control group (164.68±8.93) s and re operation (131.23±7.91) s. The adjustment times (3) and operation time (3.50±0.71) s of experimental group were significantly shorter than those of control group(11)and operation time(139.00±5.66) s ( CONCLUSION The modular combined elastic compression device has good fitness, better placement and flexible adjustment, convenience and safety, and better comfort than modified Robert Jones bandage of 3M elastic bandage.
Adolescent ; Adult ; Compression Bandages ; Female ; Humans ; Lower Extremity ; Male ; Pain Measurement ; Pressure ; Treatment Outcome ; Young Adult

No abstract available.
Aneurysm, False ; Blood Pressure Monitors ; Blood Pressure ; Compression Bandages ; Humans ; Radial Artery