School of Textiles and Design, Heriot-Watt University, United Kingdom.
Burns. 2013 Sep;39(6):1073-82. doi: 10.1016/j.burns.2013.05.012. Epub 2013 Jun 20.
Pressure garments are used in the treatment of hypertrophic scarring following serious burns. The use of pressure garments is believed to hasten the maturation process, reduce pruritus associated with immature hypertrophic scars and prevent the formation of contractures over flexor joints. Pressure garments are normally made to measure for individual patients from elastic fabrics and are worn continuously for up to 2 years or until scar maturation. There are 2 methods of constructing pressure garments. The most common method, called the Reduction Factor method, involves reducing the patient's circumferential measurements by a certain percentage. The second method uses the Laplace Law to calculate the dimensions of pressure garments based on the circumferential measurements of the patient and the tension profile of the fabric. The Laplace Law method is complicated to utilise manually and no design tool is currently available to aid this process. This paper presents the development and suggested use of 2 new pressure garment design tools that will aid pressure garment design using the Reduction Factor and Laplace Law methods. Both tools calculate the pressure garment dimensions and the mean pressure that will be exerted around the body at each measurement point. Monitoring the pressures exerted by pressure garments and noting the clinical outcome would enable clinicians to build an understanding of the implications of particular pressures on scar outcome, maturation times and patient compliance rates. Once the optimum pressure for particular treatments is known, the Laplace Law method described in this paper can be used to deliver those average pressures to all patients. This paper also presents the results of a small scale audit of measurements taken for the fabrication of pressure garments in two UK hospitals. This audit highlights the wide range of pressures that are exerted using the Reduction Factor method and that manual pattern 'smoothing' can dramatically change the actual Reduction Factors used.
压力衣用于治疗严重烧伤后的增生性瘢痕。使用压力衣被认为可以加速成熟过程，减轻未成熟增生性瘢痕引起的瘙痒，并防止屈肌关节挛缩。压力衣通常由弹性织物为个体患者量身定制，并连续佩戴长达 2 年或直至瘢痕成熟。有 2 种制作压力衣的方法。最常见的方法称为“减少因子法”，涉及将患者的周径测量值减少一定百分比。第二种方法使用拉普拉斯定律根据患者的周径测量值和织物的张力分布来计算压力衣的尺寸。拉普拉斯定律法手动使用较为复杂，目前没有设计工具可以辅助此过程。本文介绍了 2 种新的压力衣设计工具的开发和建议使用方法，它们将有助于使用减少因子法和拉普拉斯定律法进行压力衣设计。这两种工具都计算压力衣的尺寸和在每个测量点处将施加在身体周围的平均压力。监测压力衣施加的压力并注意临床结果，将使临床医生能够了解特定压力对瘢痕结果、成熟时间和患者依从率的影响。一旦确定了特定治疗的最佳压力，本文所述的拉普拉斯定律法可用于向所有患者提供这些平均压力。本文还介绍了对英国两家医院制作压力衣的测量进行小规模审核的结果。该审核突出了使用减少因子法施加的压力范围很广，并且手动模板“平滑”可以极大地改变实际使用的减少因子。
