The assessment of erythema and thickness on burn related scars during pressure garment therapy as a preventive measure for hypertrophic scarring

Van den Kerckhove, Eric; Stappaerts, Karel; Fieuws, Steffen; Laperre, Jan; Massage, Patrick; Flour, Mieke; Boeckx, Willy

doi:10.1016/j.burns.2005.04.014

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Volume 31, Issue 6 , Pages 696-702, September 2005

The assessment of erythema and thickness on burn related scars during pressure garment therapy as a preventive measure for hypertrophic scarring

Eric Van den Kerckhove
- Burn Center of the Universitaire Ziekenhuizen Leuven, Deptartment Physical Medicine and Rehabilitation and Burns Center, Herestraat 49, 3000 Leuven, Belgium
- Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences of the Katholieke Universiteit Leuven, Belgium
- Corresponding author. Tel.: +32 16 342181; fax: +32 16 348723.
Karel Stappaerts
- Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences of the Katholieke Universiteit Leuven, Belgium
Steffen Fieuws
- Biostatistical centre of the Katholieke Universiteit Leuven, Belgium
Jan Laperre
- Centexbel, Scientific and Technical Centre of the Belgian Textile Industry, Zwijnaarde, Belgium
Patrick Massage
- Burn Center of the Military Hospital, Neder-over-Heembeek, Belgium
Mieke Flour
- Department of Dermatology of the Universitaire Ziekenhuizen Leuven, Belgium
Willy Boeckx
- Plastic Surgeon, Head of the Department of Plastic Surgery of the Academische Ziekenhuizen Maastricht, The Netherlands

Accepted 19 April 2005.

Abstract

The aim of this study was threefold: (1) Assess the pressure loss of two types of pressure garments that are used in the treatment of hypertrophic scars after burn injury, (2) investigate the influence of two different levels of compression on erythema and thickness of burn scars and (3) examine the association between erythema and thickness. The study was a prospective trial in which 76 burn scars in 60 patients were objectively assessed with the Minolta Chromameter CR-300 for erythema and with the Dermascan C for thickness of the scar over a period of 3 months. Each patient was randomly assigned to a “normal” or “lower” compression class treatment, with respectively mean values of 15 and 10mmHg pressure after wearing the garment for 1 month. Measurements for both parameters were taken at 0, 1, 2 and 3 months of treatment.

Pressure garments with “normal” compression did lose significantly more compression over 1 month (4.82mmHg) than did the garments from the low compression class (2.57mmHg).

Scars that were treated with garments from a “normal” compression class did score significantly better for thickness compared to the “low” compression class. The difference in thickness was most evident at 1 month. Thereafter no further significant improvement between the two different treatments over time could be obtained. This difference was not found for erythema.

Positive correlations could be found between erythema and thickness values at all of the three test points while changes in erythema and thickness only correlated significantly after the first month.

The pattern of change of both parameters correlated at a high level of significance after 3 months of treatment.

These data suggest that pressure garments that deliver a pressure of at least 15mmHg pressure tend to accelerate scar maturation and that measurements of the pattern of change of the erythema can be used to predict changes in scar thickness and vice versa.

Keywords: Burns, Scar, Pressure therapy, Rehabilitation