Julius — the little helper for scar therapy

Julius informs

Frequently asked questions (FAQs)

Here’s where you will find lots of useful answers to questions that other children or their families have already asked. To give you a better overview, we have split the answers up into five sections. Simply click on each one to find out more!

Why does the compression garment need to be so tight?

Guido Sinram, Mannheim (Germany):
By applying pressure to the scar, the compression garment ensures that the connective tissue within the scar arranges itself in the softest and smoothest way possible. This is the only way that the scar therapy can be successful and provide the other benefits as well.

Anke Dierks, Hannover (Germany):
To prevent itchiness and to act as a “second skin” for the injured skin.

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After taking off the compression garment, I can see an imprint of its seams and pattern on the skin. Is that normal?

Roland Meissl, Mannheim (Germany):
Yes, that’s a sign that the compression is having an effect. These imprints will disappear after a short time.

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How long should the compression garment be worn?

Dr. Bettina Lange, Mannheim (Germany):
Up to two years, generally speaking.

Guido Sinram, Mannheim (Germany):
That depends on the activity of the scar. When the scar is pale and no longer shows any reddening, we call this an inactive scar that will no longer change. This inactivity sets in 1 – 2 years after the injury. After that time, it is no longer necessary to wear the compression garment any more.

Carmen Engelmann, Leipzig (Germany):
The overall wearing period will ultimately be determined by the treating physician.

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Can I apply cream to the skin under the compression garment?

Carmen Engelmann, Leipzig (Germany):
Yes, you can apply cream as normal under the garment.

Guido Sinram, Mannheim (Germany):
The cream should be fully absorbed before putting on the compression garment. Too much residual ointment can collect within the mesh of the compression garment and prevent it from contracting. This would result in a loose, medically ineffective and greasy garment (see Washing your compression garment).

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In the usage instructions for my compression garment it says not to use any paraffin-containing ointments.

Guido Sinram, Mannheim (Germany):
As mentioned above, you should avoid allowing larger quantities of ointment to get into the compression fabric. A thin film of ointment will not damage the compression fabric, though.

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When do I get a new garment?

Carmen Engelmann, Leipzig (Germany):
You should always have two well-fitting garments. If the garment no longer fits well due to a change in weight or circumference or due to growth, a new one should be measured up.

Guido Sinram, Mannheim (Germany):
In the case of children, the fit should be checked every 2-3 months to ensure that an ill-fitting garment is replaced quickly.

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My compression garment is damaged. What do I do now?

Guido Sinram, Mannheim (Germany):
Please contact your treating physician or medical products supplier. You will need to apply for a replacement garment through your health fund. A frank and open discussion with a representative of the health fund would be very useful in this case.

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Does the compression garment protect against sunlight?

Roland Meissl, Mannheim (Germany):
That depends on the manufacturer and the material used. There are compression fabrics that have a proven UV protection factor of 80, but there also ones that offer no protection. Please ask your specialist supplier about this.

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Am I allowed to wash the compression garment?

Guido Sinram, Mannheim (Germany):
Of course!

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How do I wash the compression garment?

Anke Dierks, Hannover (Germany):
At 40 °C (105 °F) using a laundry detergent for delicate fabrics, and without fabric softener. Please don’t use a clothes dryer.

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I can no longer get the ointment out of the compression fabric when I wash it

Guido Sinram, Mannheim (Germany):
Most compression fabrics are able to be washed at 60 °C (140 °F) every now and then. You should only do so in exceptional cases, though. Please check with your medical products supplier first.

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How often should I wash the compression garment?

Guido Sinram, Mannheim (Germany):
The compression garment needs to be washed every day!

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I have only one compression garment. How do I achieve a wearing period of 23 hours when I have to wash and dry it?

Guido Sinram, Mannheim (Germany):
You really ought to have a spare garment for hygienic reasons. Please speak to your medical products supplier and/or physician.

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Can I apply cream to the skin under a silicone pad?

Guido Sinram, Mannheim (Germany):
Creams are an essential part of skin and scar care. Under the silicone, the scar becomes soft and supple. You should also apply an oily cream once a day. Do not place the silicone pad on top straight away, though. Please wait until the cream has fully absorbed. Otherwise you might experience skin reactions.

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How do I clean the silicone pads?

Guido Sinram, Mannheim (Germany):
If they're the type of silicone pads with an adhesive side, you can clean them with warm water and soap and then leave them to dry in a dust-free location. Specially produced silicone inserts or pads can and should be placed in boiling water for a few minutes every two days.

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The edges of the silicone films or pads leave a strong mark on the skin when I take off the compression garment.

Roland Meissl, Mannheim (Germany):
That is normal. Due to the compression, everything located between the compression garment and the skin will be “transferred” to it. If it is only an imprint, then that is normal. If in doubt, take a photograph and forward it to your medical products supplier for them to cast a trained eye over it.

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When can the patient shower/bath again?

Dr. Bettina Lange, Mannheim (Germany):
Immediately after wound healing is complete.

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Is it OK for soap to come into contact with the scars?

Dr. Bettina Lange, Mannheim (Germany):
Not a problem.

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Are there creams specifically for scars?

Dr. Bettina Lange, Mannheim (Germany):
Yes, very many, however they are often expensive and without proof of efficacy. We recommend silicone-containing creams, but these are generally not covered by health funds. It is also possible to use a silicone pad in body areas where a patch can hold well.

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When can my child go back to baby swimming/swimming lessons at the pool?

Dr. Bettina Lange, Mannheim (Germany):
Anytime once wound healing is complete and the scars are stable. The activity should be limited to 10-15 minutes initially. Then shower well, dry off and treat the skin.

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Can my child go in a wading pool/swimming pool during the summer?

Dr. Bettina Lange, Mannheim (Germany):
Anytime once the scars are irritation-free and stable. For the first 6 months after the accident, the activity should be limited to 15-30 minutes, and a UV protection factor 50 water-resistant sunscreen should be worn. If you are planning a holiday, you may wish to purchase “sun protection clothing” (if you can afford it).

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Do you recommend a particular sunscreen?

Dr. Bettina Lange, Mannheim (Germany):
No, and it doesn't have to be expensive or purchased from a drugstore either. The sunscreens from regular supermarket chains are well tested and adequate.

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Can my child take part in school sports/club sports again?

Dr. Bettina Lange, Mannheim (Germany):
Yes, exercise with friends is good.

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What happens after inpatient treatment is concluded?

Dr. Bettina Lange, Mannheim (Germany):
As a rule, you can expect a follow-up consultation every three months at a specialized outpatient consulting suite to review the injury and to verify the progress of the conservative scar therapy.

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Will my child require physiotherapy, occupational therapy and/or scar massage after discharge?

Dr. Bettina Lange, Mannheim (Germany):
Yes, if there are any injuries that extend over a joint. These measures will be prescribed by the pediatrician or during the outpatient consultation.

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Julius experts

Our specialists are well versed in all aspects of compression therapy:

Mevlüde Em

Mevlüde Em

was born in 1966 on the Black Sea and came to Hannover (Germany) as a child. In 1986 she commenced her training as an orthotist, and in her second year she was already producing compression garments herself. Today she is regarded as a leading expert in scar therapy at the orthopaedics and rehabilitation company Teraske in Hannover. Since 2005, Ms. Em has been working at the burns clinic at the Children’s Hospital in Hannover. She is a founding member of the German Association for Scar Therapy (DBNT).

Carmen Engelmann

Carmen Engelmann

was born in 1963 in Schkeuditz in Saxony (Germany). She now works not very far from her home town, in the Wolf medical supply store in Leipzig. Ms. Engelmann started working as an orthotist in 1996 and two years after that specialized in scar therapy for adults and children. She is a recognized expert in this area and a member of the German Association for Scar Therapy (DBNT).

Roland Meissl

Roland Meissl

took the orthopedic technician examination in Kempten (Germany) and has been working at the nationally renowned medical supply store Fuchs+Möller since 2011. Mr. Meisl has been involved in the area of severe pediatric burn injuries and scar therapy since 2013, and is an active member of the German Association for Scar Therapy (DBNT).

Guido Sinram

Guido Sinram

was born in 1969 in Hamburg (Germany) where he also completed his training as an orthopedic technician. Mr. Sinram relocated to Mannheim in 1995 to sit a Master Craftsman's examination. In 2007 he specialized in the area of severe paediatric burn injuries and scar therapy and is a co-founder of the Scar Therapy Network and the German Association for Scar Therapy (DBNT).

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