Pressure garments are used to treat scars after major trauma such as burns to suppress the
over development of scars. Pressure garments can alleviate the patients discomfort caused
by the appearance of the developing scar tissue as well as pain and itching that can be
experienced. Some hospitals have in house teams making bespoke pressure garments for
patients. The current method used in UK hospitals applies a reduction factor of between
10 and 20% to produce garments. There is little evidence of the pressure delivered by
in-house or any pressure garments as pressure sensor equipment is often not available,
time consuming and difficult to use and therefore pressure is not measured in clinics at
garment fitting. An audit of pressures delivered by 8 previously made pressure garments
was conducted. The fabric that had been used to make those garments was tested and a
Pressure Garment Design (PGD) Tool was made based on the equations generated from
this test data. The historical patient and garment dimensions were entered to the PGD
tool. The audit showed that the reduction factor of 20% had exerted between 15mmHg
and 54mmHg on these patient’s limbs.
A pilot study was then undertaken to compare the standard 20% reduction factor method
to the ‘Laplace Law’ method of calculating pressure garment dimensions using a PGD
tool. 4 participants were enrolled in the study. Three garments were produced for each
participant to trial, one using the reduction method currently used and two that were
designed to exert known pressures of 15mmHg and 25mmHg. The garments were worn
and washed in rotation for approximately 8 weeks. As is standard practise in clinic, all
garments were assessed by the therapist to ensure they were suitable for use by the
Participant and the scars assessed for maturation. Prior to issuing the garments and during
the study the pressure delivered by the garments was measured using a PICOPRESS
pressure monitor.
The manual method of calculating garment dimensions using a calculator is time
consuming and less accurate than The Pressure Garment Design tool, which proved easy
to use, and versatile for the quick adjustment of measurement and pressure values for
producing finished garment dimensions. The measuring process and resulting data
highlighted problems with measuring pressure on such small limbs. The pressure
delivered using all garments varied on the individual due to variations in soft tissue and
bony areas and an ability to only measure pressure on flatter body parts of the smallest limbs, which indicates that pressure readings taken on the individual may not be a true
indication of the average pressure delivered.
The data collected from the Pressure Garment design tool, predicted pressures and the
pressure readings on the cylinder, confirmed that the Pressure Garment Design Tool can
be used to produce garments capable of delivering a known pressure, and that the
reduction factor method delivers a varied pressure in an individual garment on different
limb circumferences ranging from 52mmHg on a 17.2cm circumference to 15mmHg on
a 37.2cm circumference
