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Volume 38 Issue 12
Dec.  2022
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2022  >  38(12): 1126-1132
Ma Qimin, Liu Xiaobin, Wu Guosheng, et al. Retrospective cohort study on the coagulation characteristics of adult patients with extensively severe burn in shock stage and its alarming value[J]. Chin j Burns, 2021, 37(2): 150-156. DOI: 10.3760/cma.j.cn501120-20200907-00402
Citation: Song CH,Li JB,Lan W,et al.Effects and mechanism of pressure treatment on hemodynamic changes in patients with hypertrophic scar secondary to extensive burns[J].Chin J Burns Wounds,2022,38(12):1126-1132.DOI: 10.3760/cma.j.cn501225-20220616-00235.
shu

Effects and mechanism of pressure treatment on hemodynamic changes in patients with hypertrophic scar secondary to extensive burns

doi: 10.3760/cma.j.cn501225-20220616-00235
  • 1.

    Medical Imaging Department, Guangdong Industrial Injury Rehabilitation Hospital, Guangzhou 510440, China

  • 2.

    Occupational Therapy Department, Guangdong Industrial Injury Rehabilitation Hospital, Guangzhou 510440, China

  • 3.

    Burn Rehabilitation Department, Guangdong Industrial Injury Rehabilitation Hospital, Guangzhou 510440, China

  • 4.

    Industrial Injury Management Department, Guangdong Industrial Injury Rehabilitation Hospital, Guangzhou 510440, China

  • 5.

    Physical Therapy Department, Shanghai First Rehabilitation Hospital, Shanghai 201600, China

Funds:

Medical Science and Research Fund of Guangdong Province of China A2016523

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    Abstract
  •   Objective  To investigate the hemodynamic changes of the main arteries and veins of the extremities and the heart in patients with hypertrophic scar secondary to extensive burns after pressure treatment, and to analyze the relevant mechanisms.  Methods  A retrospective before-after self-control study was conducted. From January 2017 to February 2022, 37 patients with hypertrophic scar secondary to extensive burns who met the inclusion criteria were hospitalized in the Burn Rehabilitation Department of Guangdong Industrial Injury Rehabilitation Hospital, including 25 males and 12 females, aged 23-52 years. The patients were admitted to the hospital within 12 weeks after wound healing, and within one week after admission, rehabilitation therapists, occupational therapists, and tailors custom-made pressure products such as full-body pressure garment, pressure pants, vests, split finger gloves, split finger socks, hoods, and plastic collars, with the pressure at each part maintained at 2.67-4.00 kPa when wearing. Before the first treatment with pressure products (hereinafter referred to as before pressure treatment) and at 1 h of the first treatment with pressure products (hereinafter referred to as 1 h of pressure treatment), color Doppler ultrasonography was performed to check the pulse rate of the axillary artery, the lumen diameter, peak systolic velocity (PSV), and resistance index of the axillary artery and femoral artery on the left side, the lumen diameter, cross-sectional area, and average blood flow velocity of the axillary vein and femoral vein, and the mitral valve E peak, mitral valve A peak, tricuspid valve E peak, aortic valve PSV, and pulmonary valve PSV of the heart; an optical chromatographic skin detector was used to detect the red color, red pigment, and surface brightness of the scar on the back of the hand to reflect the filling and distribution of the scar microvessels. Data were statistically analyzed with paired sample t test.  Results  Compared with those before pressure treatment, the PSV of the axillary artery of patients was significantly slowed down at 1 h of pressure treatment (t=55.42, P<0.01); the average blood flow velocity of the axillary vein was significantly accelerated (t=-60.50, P<0.01); the pulse rate, lumen diameter, and resistance index of the axillary artery, as well as the lumen diameter and cross-sectional area of the axillary vein did not change obviously (P>0.05); the average blood flow velocity of the femoral vein was significantly accelerated (t=-80.52, P<0.01); the lumen diameter, PSV, and resistance index of the femoral artery, as well as the lumen diameter and cross-sectional area of the femoral vein had no significant change (P>0.05); the mitral valve E peak and mitral valve A peak of the heart decreased significantly (with t values of 10.71 and 21.96, respectively, P<0.01); the tricuspid valve E peak of the heart increased significantly (t=7.57, P<0.01); the PSV of the aortic valve and pulmonary valve of the heart did not change obviously (P>0.05). At 1 h of pressure treatment, the red color and red pigment values of the scar on the back of the hand of patients were 15.3±1.1 and 16.8±1.2, respectively, which were significantly lower than 24.5±1.3 and 23.8±1.2 before pressure treatment (with t values of 8.32 and 8.04, respectively, P<0.01). The brightness value of the scar surface on the back of the hand of patients at 1 h of pressure treatment was similar to that before pressure treatment (P>0.05).  Conclusions  After pressure treatment for the hypertrophic scar in patients secondary to extensive burn, the average blood flow velocity of the axillary vein and femoral vein in patients are obviously accelerated, the PSV of the axillary artery is significantly slowed down, the peak values of mitral valve E and mitral valve A of the heart are significantly decreased, and the tricuspid valve E peak is significantly increased. These hemodynamic changes may be related to the reduction of microvascular blood flow in the local area of scar after systemic pressure treatment.

     

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    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 2.2 %其他: 2.2 %其他: 0.8 %其他: 0.8 %Auckland: 0.1 %Auckland: 0.1 %三明: 1.0 %三明: 1.0 %三门峡: 0.3 %三门峡: 0.3 %上海: 0.7 %上海: 0.7 %丽水: 0.7 %丽水: 0.7 %乌鲁木齐: 0.2 %乌鲁木齐: 0.2 %乐山: 0.6 %乐山: 0.6 %六安: 0.1 %六安: 0.1 %兰州: 0.3 %兰州: 0.3 %包头: 0.7 %包头: 0.7 %北京: 0.7 %北京: 0.7 %南京: 0.4 %南京: 0.4 %南充: 0.1 %南充: 0.1 %南宁: 0.1 %南宁: 0.1 %南平: 0.7 %南平: 0.7 %南昌: 0.2 %南昌: 0.2 %南通: 0.8 %南通: 0.8 %厦门: 0.3 %厦门: 0.3 %台州: 1.6 %台州: 1.6 %合肥: 0.5 %合肥: 0.5 %吉林: 1.4 %吉林: 1.4 %咸阳: 0.8 %咸阳: 0.8 %哥伦布: 0.2 %哥伦布: 0.2 %唐山: 0.7 %唐山: 0.7 %嘉兴: 1.3 %嘉兴: 1.3 %多特蒙德: 0.1 %多特蒙德: 0.1 %大连: 1.0 %大连: 1.0 %天津: 0.1 %天津: 0.1 %太原: 0.4 %太原: 0.4 %宁德: 0.7 %宁德: 0.7 %宁波: 0.8 %宁波: 0.8 %安康: 1.0 %安康: 1.0 %宜宾: 0.2 %宜宾: 0.2 %宜春: 0.5 %宜春: 0.5 %宿迁: 1.4 %宿迁: 1.4 %常德: 0.6 %常德: 0.6 %广元: 0.4 %广元: 0.4 %广安: 0.2 %广安: 0.2 %广州: 2.5 %广州: 2.5 %廊坊: 0.2 %廊坊: 0.2 %延安: 2.0 %延安: 2.0 %张家口: 1.2 %张家口: 1.2 %徐州: 0.5 %徐州: 0.5 %德州: 0.1 %德州: 0.1 %德阳: 0.2 %德阳: 0.2 %扬州: 0.9 %扬州: 0.9 %抚州: 1.5 %抚州: 1.5 %抚顺: 0.5 %抚顺: 0.5 %无锡: 0.8 %无锡: 0.8 %昆明: 0.2 %昆明: 0.2 %普赖恩维尔: 0.1 %普赖恩维尔: 0.1 %朝阳: 0.2 %朝阳: 0.2 %杭州: 1.1 %杭州: 1.1 %枣庄: 0.1 %枣庄: 0.1 %桂林: 0.4 %桂林: 0.4 %梅州: 0.2 %梅州: 0.2 %榆林: 1.9 %榆林: 1.9 %武汉: 0.2 %武汉: 0.2 %毕节: 0.2 %毕节: 0.2 %氹仔: 0.1 %氹仔: 0.1 %汕头: 0.9 %汕头: 0.9 %池州: 0.5 %池州: 0.5 %沃思堡: 0.2 %沃思堡: 0.2 %沈阳: 1.0 %沈阳: 1.0 %泉州: 0.9 %泉州: 0.9 %泰安: 0.2 %泰安: 0.2 %泰州: 0.7 %泰州: 0.7 %泸州: 0.7 %泸州: 0.7 %洛阳: 0.1 %洛阳: 0.1 %济南: 2.0 %济南: 2.0 %海口: 0.3 %海口: 0.3 %海得拉巴: 0.2 %海得拉巴: 0.2 %海西: 0.1 %海西: 0.1 %淮北: 0.4 %淮北: 0.4 %淮安: 1.0 %淮安: 1.0 %温州: 1.5 %温州: 1.5 %渭南: 1.4 %渭南: 1.4 %湖州: 0.7 %湖州: 0.7 %湘潭: 0.7 %湘潭: 0.7 %湘西: 0.6 %湘西: 0.6 %漯河: 0.2 %漯河: 0.2 %漳州: 1.4 %漳州: 1.4 %潍坊: 0.1 %潍坊: 0.1 %烟台: 0.2 %烟台: 0.2 %珠海: 0.1 %珠海: 0.1 %盐城: 0.8 %盐城: 0.8 %盘锦: 0.9 %盘锦: 0.9 %石家庄: 0.1 %石家庄: 0.1 %福州: 0.2 %福州: 0.2 %秦皇岛: 0.7 %秦皇岛: 0.7 %米兰: 0.2 %米兰: 0.2 %红河: 0.2 %红河: 0.2 %绍兴: 1.1 %绍兴: 1.1 %绵阳: 0.3 %绵阳: 0.3 %自贡: 0.3 %自贡: 0.3 %舟山: 0.2 %舟山: 0.2 %芒廷维尤: 8.5 %芒廷维尤: 8.5 %芜湖: 0.9 %芜湖: 0.9 %苏州: 0.9 %苏州: 0.9 %荆门: 1.0 %荆门: 1.0 %莆田: 2.0 %莆田: 2.0 %营口: 0.4 %营口: 0.4 %葫芦岛: 0.1 %葫芦岛: 0.1 %蚌埠: 0.2 %蚌埠: 0.2 %衡水: 0.2 %衡水: 0.2 %衢州: 0.8 %衢州: 0.8 %襄阳: 0.8 %襄阳: 0.8 %西宁: 1.8 %西宁: 1.8 %西安: 2.6 %西安: 2.6 %许昌: 0.1 %许昌: 0.1 %诺沃克: 0.1 %诺沃克: 0.1 %贵阳: 0.4 %贵阳: 0.4 %赣州: 0.1 %赣州: 0.1 %辽阳: 0.8 %辽阳: 0.8 %运城: 0.1 %运城: 0.1 %连云港: 1.2 %连云港: 1.2 %遵义: 1.1 %遵义: 1.1 %邯郸: 0.1 %邯郸: 0.1 %邵阳: 0.5 %邵阳: 0.5 %郑州: 0.1 %郑州: 0.1 %郴州: 1.7 %郴州: 1.7 %鄂州: 0.2 %鄂州: 0.2 %重庆: 5.1 %重庆: 5.1 %金华: 0.8 %金华: 0.8 %铁岭: 1.1 %铁岭: 1.1 %铜陵: 1.1 %铜陵: 1.1 %锦州: 0.2 %锦州: 0.2 %长沙: 0.3 %长沙: 0.3 %雅安: 0.2 %雅安: 0.2 %青岛: 0.1 %青岛: 0.1 %鞍山: 1.7 %鞍山: 1.7 %香港: 0.2 %香港: 0.2 %鹰潭: 1.0 %鹰潭: 1.0 %黄冈: 0.5 %黄冈: 0.5 %黄南: 0.2 %黄南: 0.2 %黄山: 0.8 %黄山: 0.8 %黄石: 0.5 %黄石: 0.5 %黔西南: 0.4 %黔西南: 0.4 %其他其他Auckland三明三门峡上海丽水乌鲁木齐乐山六安兰州包头北京南京南充南宁南平南昌南通厦门台州合肥吉林咸阳哥伦布唐山嘉兴多特蒙德大连天津太原宁德宁波安康宜宾宜春宿迁常德广元广安广州廊坊延安张家口徐州德州德阳扬州抚州抚顺无锡昆明普赖恩维尔朝阳杭州枣庄桂林梅州榆林武汉毕节氹仔汕头池州沃思堡沈阳泉州泰安泰州泸州洛阳济南海口海得拉巴海西淮北淮安温州渭南湖州湘潭湘西漯河漳州潍坊烟台珠海盐城盘锦石家庄福州秦皇岛米兰红河绍兴绵阳自贡舟山芒廷维尤芜湖苏州荆门莆田营口葫芦岛蚌埠衡水衢州襄阳西宁西安许昌诺沃克贵阳赣州辽阳运城连云港遵义邯郸邵阳郑州郴州鄂州重庆金华铁岭铜陵锦州长沙雅安青岛鞍山香港鹰潭黄冈黄南黄山黄石黔西南

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      沈阳化工大学材料科学与工程学院 沈阳 110142

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