Pressure therapy is a standard treatment to prevent hypertrophic scars (mainly burn scars). Pressure therapy involves wearing garments made from elasticized fabrics or wearing masks/collars made from hard materials maybe with a silicone top layer. The exact reason why pressure works is still not fully understood. It’s thought that pressure controls collagen synthesis and limits the supply of blood, oxygen and nutrients to the scar tissue. It may also have a role in reducing inflammation.
Scars and skin graft donor sites need regular creaming (moisturisation) to prevent the area from drying, cracking and becoming sore. The oil glands in your skin which usually provide moisture can be damaged or destroyed by the injury. The surface layer of the skin which prevents water loss is damaged. Therefore, the healed skin lacks the moisture needed. Silicone works by sealing in the moisture and hydrating the scar. Through providing occlusion (covering) and hydration to the outer layer of the epidermis evaporation of water is reduced from the skin. Silicone treatment aims to flatten, soften and reduce the redness and discomfort of your scar over time. Silicones possess many skin-friendly properties; they are easy to use and remove, painless, can be worn for long periods, are resistant to microbial growth, and are waterproof.
Vacuum massage is also known as depressomassage, vacuotherapy or Endermologie®. It is a non-invasive mechanical massage technique. It is performed with a mechanical device that lifts the skin by suction and creates a skin fold which can be mobilised. In the late 1970s, Louis-Paul Guitay developed the Endermologie® system (or LPG), this uses both suction (negative pressure) and mechanised rollers to mimic manual massage. LPG can provide consistent and effective treatment in a shorter time. Treatment sessions are painless and vary from 10 minutes to longer depending on the state and size of the scar.
Extracorporeal shock wave therapy (ESWT) is a type of pulsed acoustic wave resulting from excessive pressure changes. It has been used to treat musculoskeletal diseases (plantar fasciitis, lateral epicondylitis of the elbow, etc.) and wounds. Recent research has shown that ESWT is effective in stimulating biological activities that involve cellular activity. These results suggest that ESWT improves blood perfusion and can be used in tissue regeneration/ scar remodelling. Shockwave treatment is performed without anaesthesia; a treatment head and gel are applied to the area of scar treated.
People who sustain burn injuries can experience reduced activity performance due to periods of immobilisation, ventilator dependence, the burn-related catabolic response, pain, limiting scars, muscle weakness and reduced fitness levels. High levels of fatigue may also be experienced. Many of these problems can be more noticeable after discharge from hospital.
