Pruritus in Adult Burn Survivors

Carrougher, Gretchen J.; Martinez, Erin; McMullen, Kara; Fauerbach, James A.; Holavanahalli, Radha; Herndon, David N.; Wiechman, Shelley A.; Engrav, Loren H.; Gibran, Nicole S.

doi:10.1097/bcr.0b013e3182644c25

Cited by 102 publications

(29 citation statements)

References 16 publications

(26 reference statements)

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“…These findings correspond to longitudinal studies of burn scars (Li-Tsang et al, 2015;Carrougher et al, 2013;Stella et al, 2008). However, evidence of the effect of IPGT on itch and pain remains anecdotal as no differences between the groups over time were found possibly due to such low participant numbers therefore further testing with a larger number of participants is required to establish the effectiveness of IPGT for reducing itch and pain.…”

Section: Discussionmentioning

confidence: 88%

“…Donor sites share many characteristics of wound healing associated with partial thickness burns, such as increased risk of pain, infection, abnormal scar formation and itch Carrougher et al, 2013;Nedelec et al, 2014). All donor sites have been identified as being at risk of scarring (Batkin et al, 2013) and furthermore donor scars do not resemble normal skin for at least 12 months post-harvest (Nedelec et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…(Demirtas, Yagmur, Soylemez, Ozturk & Demir, 2010;Markl et al, 2010;Atiyeh, Al-Amm and Nasser, 2002;Läuchli et al, 2013;McBride, Kimble, Stockton, 2014). Donor site wounds may have adverse consequences for the patient such as symptoms of pain and itch, and infection that can dramatically impact daily living Carrougher et al, 2013). Furthermore, all donor sites have been identified as being at risk of scarring (Batkin & Maitz, 2013) and donor scarring has been found to take at least 12 months post-harvest to resemble normal skin (Nedelec, Correa, de Oliveira, LaSalle & Perrault, 2014).…”

Section: Acknowledgementsmentioning

confidence: 99%

“…This can give rise to additional physical and psychological issues associated with burn injury such as cosmesis, pain and pruritus (itching) (Druery et al, 2005;Carrougher et al, 2013). Donor sites have been shown to be significantly more erythematous than normal skin during healing at 6 and 12 months and do not return to normal skin colour for up to 12 months post-harvest (Nedelec et al, 2014).…”

Section: Donor Cosmesis Pain and Pruritusmentioning

confidence: 99%

“…The disruption of the integrity of the skin during STSG harvesting results in a new, often painful and unexpected wound for the patient (Demirtas et al, 2009). s33634065 8 | P a g e Protection of the remaining epidermal and dermal elements of the donor site is required to assist effective wound healing with minimal scarring, reduced pain and itch (Muller, Gahankari & Herndon, 2007;Ripper et al, 2009;Clark, Cheng & Leung, 1996;Bloemen et al, 2009;Gurtner, 2007;Carrougher et al, 2013;Atiyeh et al, 2002).…”

Section: Split Thickness Skin Grafting (Stsg)mentioning

confidence: 99%

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Interim pressure garment therapy: an investigation into the use of low level pressure therapy for burns donor site support and scar management

Donovan¹

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Split Thickness Skin Grafting (STSG) is a well-known and established procedure for healing burn wounds throughout the world. The procedure requires the removal of the epidermal and part of the dermal layer of the skin. It leaves intact the deep reticular dermal layer which is known as the donor site, and has sufficient cells to regenerate the excised superficial layers. STSG provides wound closure and accelerated healing for the burn wound, and there is great importance surrounding the success of graft take and scar management thereafter (Demirtas et al, 2009; Atiyeh et al, 2002). The presence of donor sites, though created to assist healing of the burn site, in fact creates an additional wound for the patient which often causes further psychological stress at a traumatic time in the healing process (Andrews, Brown, Drummond, & Wood, 2010). Donor sites are consistently identified as a particularly painful wound by burn patients. Pain associated with burn surgery has been shown to delay the patients return to work and daily functional activity (Wisley et al, 2010; Druery et al, 2005; Brown et al, 2008). Thus, protection of the remaining epidermal and dermal elements of this surgical wound (donor site) is required to assist effective tissue healing with minimal scarring. One intervention that may accelerate healing and reduce scar formation is the use of Interim Pressure Garment Therapy (IPGT) which applies 4-6mmHg of pressure to the thigh. This treatment has been utilised at a major Australian burns unit in Queensland by Occupational Therapists. However, this has involved inconsistent application with a focus on securing wound dressing rather than scar management. Despite this, anecdotal and observational evidence suggests that pressure therapy also makes a difference to some patient's scar outcomes for donor sites. It is hypothesised that IPGT may improve postoperative management of donor sites through the application of a low superficial pressure that mimics normal skin tension, possibly preventing donor wound distension and subsequent micro-tears in the newly forming epidermis. Furthermore, this may reduce the effects of the inflammatory response, which may in turn give rise to a hypertrophic scar response in the later stages of the healing process. This research focuses on a unique area of burns donor site scar management. It is designed to test a low pressure tubular support garment as an intervention for the support of, and reduction of donor site scarring. No known studies of this nature have been carried out to date, suggesting there is a need for rigorous clinical evidence to support the use of these garments for donor site scar minimisation. Thereby, two studies were undertaken. The objective of the first study was to determine the pressure range (mmHg) applied by the Interim Pressure Garment Therapy (IPGT). Forty seven healthy adult volunteers were measured and fitted with a pair of Interim Pressure Garments (IPG). s33634065 ii | P a g e The garments were made onsite from a tubular knit material, simil...

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Section: Discussionmentioning

confidence: 88%