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Pressure therapy for scars: Myth or reality? A systematic review
Ignace De Decker1, Anse Beeckman2, Henk Hoeksema1
1Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Department of Plastic Surgery, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium.
Summary
Pressure therapy effectively manages hypertrophic scars by improving scar quality, color, and thickness. Optimal treatment involves early initiation (before 2 months) with 20-25 mmHg for 12-24 months.
Area of Science:
- Dermatology
- Wound Healing
- Regenerative Medicine
Background:
- Hypertrophic scarring is a common complication following burns and other injuries.
- Current treatments include hydration, UV protection, and pressure garments, but effectiveness is debated.
- Pressure therapy's mechanism may involve hypoxia and reduced fibroblast activity via TGF-β1 modulation.
Approach:
- A systematic review was conducted following PRISMA guidelines.
- Searches were performed in PubMed, Embase, and Cochrane Library databases.
- Included studies were case series, case-control, cohort studies, and RCTs, with qualitative assessment by two reviewers.
Key Points:
- 17 studies were included after screening 1458 articles.
- Investigated comparisons included pressure vs. no pressure, low vs. high pressure, and short vs. long duration.
- Key variables like adherence, wear time, and pressure amount require further understanding.
Conclusions:
- Sufficient evidence supports pressure therapy for scar prevention and treatment.
- Pressure therapy improves scar color, thickness, pain, and overall quality.
- Recommendations include starting therapy before 2 months, using 20-25 mmHg, and continuing for 12-24 months.
