Scar therapy using compression garments

When the skin has sustained deep burns or scalds, surgery is performed to transplant healthy skin from another part of the body to the damaged area. To ensure this skin transplantation does not lead to the formation of proliferative scars – which are referred to as hypertrophic scars or keloids – a special type of treatment is required. As soon as the wound has healed, a therapeutically effective external pressure is applied to the wound area. This is done with the help of compression garments, which prevent an uncontrolled and excessive reorganization of the connective tissue from occurring. When subjected to this constant external pressure, the fibrous connective tissue cells in the wound arrange themselves uniformly and parallel to the wound and skin surface.

Faster healing, flatter scars

The constant surface pressure exerted by the compression garment enables the scarred area to mature more quickly. The consistency of the raised scar begins to change within just a short time, and the scar tissue becomes softer. The red scar tissue fades and the thickness of the scar decreases. Furthermore, the compression also reduces the formation of hardened scars, and the associated joint stiffening and uncomfortable itchiness. Even long-standing scars can be reduced by compression therapy.

The scar therapy process

1 Expert selection of the compression garment

As soon as stable closure of the surgically treated wound is assured, compression therapy can begin. A medical supply store specialist will first accurately measure the young patient and check, for example, whether any pressure pads are required. The compression garment is then “custom-made”, that is, tailored to the specific body measurements of the child.

For hygienic reasons and to allow the material to regenerate, compression garments should be washed daily. Ideally, the child will receive several pairs of the compression garment as they need to wear it continuously.

2 Duration of the compression therapy

After deep second- or third-degree burns and other scars with tendency to hypertrophy the child needs to wear its compression garment for up to two years – day and night. This is necessary so that the scars do not bring any functional restrictions. The best is to interrupt the treatment only for short times during the change of the compression garment, personal hygiene and the care of the scar.

The overall duration of the compression therapy depends on a number of factors:

the severity of the scars
the location and extent of the scars
the healing reaction, which will differ for each person
the therapy acceptance and patience of the young patient and his/her family.

You should discuss the therapy duration with your physicians during follow-up consultations. We recommend quarterly follow-up appointments.

Tipp
It is essential that the compression garment be worn around the clock until the scar has fully healed. Even children will accept compression therapy well provided they are given time to get used to it.

3 Silicone therapy

Treating scars using silicone is another effective option in scar therapy.

Silicone retains the skin’s natural moisture preventing the scar area from drying out. Silicone products are made entirely from medical silicone. They are soft, highly elastic and very adaptable, which means people find the wearing experience to be pleasant rather than disruptive.

Depending on the scar and choice of the product, silicone can also be worn in combination with a compression garment. Using the silicone products early alongside compression therapy can be an ideal supplement and can boost therapeutic effectiveness:

the scar tissue becomes softer
uncontrolled growth of the scar is reduced
the fresh scar tissue or skin graft receives additional protection
direct rubbing on the skin is avoided

Silicone inserts can also be worn under compression garments at points of the body where compression alone is not enough to build up the required pressure on the scar tissue. This can be the case, for example, on the ankle or the cleavage.

4 Follow-up compression therapy

Experience and good intuition are required when checking the compression pressure. The young patient’s own assessment of the wearing comfort is also important. If any problems with the fit are identified, the child should be re-measured and new garments supplied.

The physician, therapist or staff member of the medical supply store should check, on a regular basis, that the compression garment is being used in a therapeutically correct manner. The fit of the compression garment can be compromised by improper handling, natural wear-and-tear, or through changes in the size or weight of the child. Bandages that have been applied too tightly, for example, produce an increase in pressure that can negatively impact on the movement or breathing of the patient. How frequently the fit should be checked depends on the individual. A check at least every two to three months is advised for children still in the growth phase.

Tip
Optimum outcomes in follow-up compression therapy can only be achieved through ongoing cooperation between the patient, physician, therapist, medical supply store and manufacturer of the compression garment.

5 Therapeutic follow-up treatment

Consistent wearing of the compression garment (if necessary in conjunction with silicone products), and regular skin care are the most important things during this period. The garment, in particular, plays a decisive role in reducing the long-term consequences of burns and scalds –the scars will be less visible, and not cause any functional restriction.

The following aspects are also important:

physiotherapy or occupational therapy
long-term review of the burnt or scalded areas of skin and the progress of the therapy (right through to adulthood in the case of children!)
avoidance of sun exposure
using orthopaedic training or support splints (if required)
Joining self-help groups
If necessary: psychological support

6 Operative follow-up treatment

If scars are overly sensitive or impair physical functioning – for example the freedom of movement of the arms, legs or trunk – early operative intervention can help. Aesthetic corrections can also be performed at a later time.

7 Care of the compression garment

You should wash the compression garment daily at 40 °C (105 °F), either by hand or in the machine on the gentle or delicate cycle. Before washing the garment, turn it inside out and close all fasteners. Do not use any fabric softener.

Please observe the care instructions enclosed with the compression garment or ask your specialist supplier.

Julius tips

Little helpers

Fun iron-on transfers for you!

How nice is this – we can make your compression garment really colourful! There are lots of fun designs featuring me and my friends. You can order one iron-on transfer per compression garment from your supplier.

Silicone pads for the effective and individualized treatment of scars

The silicone pad softens the scar tissue and reduces reddening of the skin. It protects the sensitive healing layer of skin and prevents any direct rubbing.
The self-adhesive Juzo ScarPad is made from 100 percent medical silicone, which makes it highly elastic and very moldable. The surface is especially soft and comfortable against the skin.

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