Using pressure therapy

Pressure Therapy Options:

• Custom made pressure garments
• Off the shelf / Ready to wear garments
• Tubigrip
• Compression Bandaging
• Combined with silicone products or inserts used beneath pressure therapy

Regime:

Start:

Once the burn is healed and can tolerate the pressure and shearing forces generated by the garment during donning, doffing and moving underneath [2]. Clinically this might present as a burn approximately 80-100% healed with the child still requiring small dressings underneath the garment to protect the healing or newly healed skin.

* Each compression garment company has their own garment measuring forms and offers training to therapists on how to accurately measure and prescribe compression garments.

Wear:

• 23 hours per day until scar is mature [2].
• Garments may be able to be removed to enable the child’s participation in specific activities (i.e. swimming, messy play; manual arts).

Remove:

• For hygiene self-care tasks
• To complete scar interventions
• If impacting on appropriate developmental play opportunities (ie elf-feeding, sensory/messyplay).
  • See Occupational Performance considerations with pressure garments
• If any signs of circulation compromise (ie altered sensations, sluggish capillary refill).
• If Impacting on underlying skin integrity (rash, blistering or pressure on skin after wear that doesn’t go away after 30 minutes of garment being removed).
• If any signs of underlying Infection

Replace/modify:

• When the child has outgrown or worn through the garment (See Top Tips Section)
• If pressure therapy is restricting the child’s participation in meaningful occupations
• Pressure garments are recommended to be replaced every 2-3 months to maintain pressure needed to obtain optimal scar outcomes [5]. However, the frequency of garment provision is restricted by budgets in most facilities. In paediatrics this typically occurs every 3-6 months depending on the child’s growth and integrity of the garment.
• In some scar locations such as the chest, padding may need to be applied beneath pressure garments to achieve optimal pressure.