Division of Trauma, Critical Care, and Burn, Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, United States.
Department of Materials Science and Engineering, Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States; Research Department, Shriners Hospitals for Children, Cincinnati, Ohio, United States.
Burns. 2019 Aug;45(5):1215-1222. doi: 10.1016/j.burns.2018.12.016. Epub 2019 Jan 7.
Compression therapy (CT) has been an important, but debated, treatment for burn scars. To better understand one source of variation in observed outcomes after CT, an evaluation of CT timing of application is needed.
Following IRB approval, 126 burn centers were contacted to complete a 17-question survey regarding the center's practice pattern for compression garment therapy. Locally, study subjects were identified between March 1, 2014 and December 31, 2015 and medical records examined for timing of garment ordering, delivery and fitting.
The majority believed that compression therapy is beneficial. Most centers reported using custom-fit and pre-fabricated garments, and a goal time of application between 2-4 weeks (42%) and 4-6 weeks (36%). After the garments are ordered, 61% of centers estimate that it takes 2-4 weeks for them to arrive. No significant differences in practices were found among centers treating pediatric patients only, adults only or both. Locally, the mean number of weeks between the date of original injury and garment order placement was 9.1 weeks with an additional 8.7 weeks between the date of order and date of delivery.
The current study identified that although the national reporting of time to garment application is estimated to be between 2-6 weeks at the majority of burn centers including our own, we found our center to be well in excess of 17 weeks. The findings offer an opportunity for local improvement, and raise the possibility of similar incongruity between goals and practice at other centers.
压迫疗法（CT）一直是治疗烧伤瘢痕的重要方法，但也存在争议。为了更好地理解 CT 应用时机对观察结果的影响，需要对 CT 应用时机进行评估。
在获得机构审查委员会批准后，联系了 126 家烧伤中心，要求其填写一份关于中心使用压迫衣治疗的实践模式的 17 个问题的调查问卷。在当地，于 2014 年 3 月 1 日至 2015 年 12 月 31 日期间确定了研究对象，并检查了其压迫衣订购、交付和适配的时间。
大多数中心认为压迫疗法是有益的。大多数中心报告使用定制和预制的压迫衣，且应用的目标时间为 2-4 周（42%）和 4-6 周（36%）。压迫衣订购后，61%的中心估计需要 2-4 周才能送达。仅治疗儿科患者、仅治疗成人患者或同时治疗成人和儿童患者的中心之间的实践差异无统计学意义。当地，从原发损伤日期到压迫衣订购日期的平均间隔为 9.1 周，从订购日期到交付日期的平均间隔为 8.7 周。
本研究表明，尽管全国大多数烧伤中心（包括我们自己的中心）报告的压迫衣应用时间估计在 2-6 周，但我们发现我们中心的时间远远超过 17 周。研究结果为局部改进提供了机会，并提出了其他中心在目标与实践之间可能存在类似差异的可能性。
