Efficacy of pressure garment therapy for the treatment of hypertrophic burn scars - Rapid Review May 2016
Dr Joanna Ford undertook a Rapid Review into this subject in Spring 2016. The original 2016 Review is available as a PDF. An updated review (Feb 2017) is also available as a PDF, but this does not change the conclusions.
Review Summary & Key Messages
Hypertrophic scarring can have significant physical, psychological and social implications for patients.
Pressure garment therapy is the standard treatment for hypertrophic scars globally and many clinicians state that it is an effective treatment that improves the outcomes for patients.
Published information in the form of solid, scientific evidence for the use of pressure garments in the treatment of hypertrophic scars is currently unavailable.
Strengths of the evidence: studies were carried out on patients with hypertrophic scars who had suffered burns and were treated in realistic scenarios (i.e. the clinical manner in which patients were treated and advised).
Weaknesses in the evidence: lack of standardisation in/between most studies (e.g. the type of pressure garments used, the specific pressures used, the part of the body under investigation)
The authors' conclusion from this review (as well as results from a previously published systematic review and meta-analysis) is that clear evidence demonstrating the clinical efficacy of PGs is currently unavailable. Studies need to be better designed and should include standardised methods of accurate pressure measurement at the garment/skin interface, use of an optimal scar assessment tool and a general consensus of what outcomes are clinically desirable.
Although a few studies demonstrate that this treatment appears to be beneficial in some cases and under some conditions, the current literature available does not provide convincing scientific evidence for its use as a hypertrophic scar treatment. Further, well designed studies are required to establish whether it is clinically beneficial and if so, the levels of pressure required for clinical efficacy.