Email Alerts
RSS
Volume 38 Issue 12
Dec.  2022
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2022  >  38(12): 1126-1132
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.
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

More Information
    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.

     

    • FullText(HTML)
  • loading
    • References(26)
  • [1]
    ChenK,RaoZ,DongS,et al.Roles of the fibroblast growth factor signal transduction system in tissue injury repair[J/OL].Burns Trauma,2022,10:tkac005[2022-06-16].https://pubmed.ncbi.nlm.nih.gov/35350443/.DOI: 10.1093/burnst/tkac005.
    [2]
    GauglitzGG,KortingHC,PavicicT,et al.Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies[J].Mol Med,2011,17(1/2):113-125.DOI: 10.2119/molmed.2009.00153.
    [3]
    MengX,YuZ,XuW,et al.Control of fibrosis and hypertrophic scar formation via glycolysis regulation with IR780[J/OL].Burns Trauma,2022,10:tkac015[2022-08-16].https://pubmed.ncbi.nlm.nih.gov/35769829/.DOI: 10.1093/burnst/tkac015.
    [4]
    ZhangJ,LiY,BaiX,et al.Recent advances in hypertrophic scar[J].Histol Histopathol,2018,33(1):27-39.DOI: 10.14670/HH-11-908.
    [5]
    王洪涛,韩军涛,胡大海.炎症反应在增生性瘢痕和瘢痕疙瘩形成中的作用及其机制研究进展[J].中华烧伤杂志,2021,37(5):490-494.DOI: 10.3760/cma.j.cn501120-20200310-00143.
    [6]
    宋菲,刘英开,王西樵.增生性瘢痕发生和演变过程中微血管和氧分压动态变化的研究[J].上海交通大学学报(医学版),2016,36(11):1553-1557.DOI: 10.3969/j.issn.1674-8115.2016.11.003.
    [7]
    周梦云,阎玉秀,金子敏,等.增生性瘢痕压力服研究与临床现状及展望[J].现代纺织技术,2021,29(5):78-87.DOI: 10.19398/j.att.202009018.
    [8]
    李曾慧平,冯蓓蓓,李奎成.烧伤后增生性瘢痕压力治疗及相关研究[J].中华烧伤杂志,2010,26(6):411-415.DOI: 10.3760/cma.j.issn.1009-2587.2010.06.002.
    [9]
    王达利.增生性瘢痕防治的研究进展与方向[J/CD].中华损伤与修复杂志:电子版,2017,12(4):247-253.DOI: 10.3877/cma.j.issn.1673-9450.2017.04.002.
    [10]
    田凌云,李映兰,吴英,等.压力疗法治疗增生性瘢痕患者有效性的荟萃分析[J].中华烧伤杂志,2019,35(9):668-675.DOI: 10.3760/cma.j.issn.1009-2587.2019.09.005.
    [11]
    赵海洋,韩军涛,刘佳琦,等.手持续被动运动系统联合功能训练与压力手套治疗手背部烧伤后早期瘢痕挛缩的效果[J].中华烧伤杂志,2021,37(4):319-326.DOI: 10.3760/cma.j.cn501120-20201020-00443.
    [12]
    中华医学会烧伤外科学分会,中国医师协会烧伤科医师分会.烧伤康复治疗指南(2013版)[J].中华烧伤杂志,2013,29(6):497-504.DOI: 10.3760/cma.j.issn.1009-2587.2013.06.001.
    [13]
    中国整形美容协会瘢痕医学分会.瘢痕早期治疗全国专家共识(2020版)[J].中华烧伤杂志,2021,37(2):113-125.DOI: 10.3760/cma.j.cn501120-20200609-00300.
    [14]
    HosseiniM,BrownJ,KhosrotehraniK,et al.Skin biomechanics: a potential therapeutic intervention target to reduce scarring[J/OL].Burns Trauma,2022,10:tkac036[2022-10-16].https://pubmed.ncbi.nlm.nih.gov/36017082/.DOI: 10.1093/burnst/tkac036.
    [15]
    ShirakamiE,YamakawaS,HayashidaK.Strategies to prevent hypertrophic scar formation: a review of therapeutic interventions based on molecular evidence[J/OL].Burns Trauma,2020,8:tkz003[2022-06-16].https://pubmed.ncbi.nlm.nih.gov/32341924/.DOI: 10.1093/burnst/tkz003.
    [16]
    ZhangH,WangHY,WangDL,et al.Effect of pressure therapy for treatment of hypertrophic scar[J].Medicine (Baltimore),2019,98(26):e16263.DOI: 10.1097/MD.0000000000016263.
    [17]
    ChowL,YickKL,SunY,et al.A novel bespoke hypertrophic scar treatment: actualizing hybrid pressure and silicone therapies with 3D printing and scanning[J].Int J Bioprint,2021,7(1):327.DOI: 10.18063/ijb.v7i1.327.
    [18]
    PriceK,MoiemenN,NiceL,et al.Patient experience of scar assessment and the use of scar assessment tools during burns rehabilitation: a qualitative study[J/OL].Burns Trauma,2021,9:tkab005[2022-06-16].https://pubmed.ncbi.nlm.nih.gov/34212058/.DOI: 10.1093/burnst/tkab005.
    [19]
    KimJD,OhSJ,KimSG,et al.Ultrasonographic findings of re-epithelialized skin after partial-thickness burns[J/OL].Burns Trauma,2018,6:21[2022-06-16].https://pubmed.ncbi.nlm.nih.gov/30123801/.DOI: 10.1186/s41038-018-0122-3.
    [20]
    宋春红. 手背瘢痕切除后移植皮片下瘢痕增生的超声检测分析[J]. 临床超声医学杂志,2016,18(1):62-64.
    [21]
    孙正.血管内超声测量血流动力学参数的研究进展[J].中国医学影像技术,2013,29(8):1393-1396.
    [22]
    宋春红,张玉霞,赵炜,等.56例重度烧伤患者康复期下肢动脉血流动力学超声表现[J].分子影像学杂志,2016,39(2):97-99.DOI: 10.3969/j.issn.1674-4500.2016.02.08.
    [23]
    王雪,杨茹茜,杨雨婷,等.20MHz高频超声对不同类型皮肤瘢痕的诊断价值[J].第三军医大学学报,2020,42(3):282-287.DOI: 10.16016/j.1000-5404.201908155.
    [24]
    LipmanK,WangM,BerthiaumeE,et al.Evaluating current scar assessment methods[J].Ann Plast Surg,2020,84(2):222-231.DOI: 10.1097/SAP.0000000000002029.
    [25]
    Li-TsangCW,LauJC,LiuSK.Validation of an objective scar pigmentation measurement by using a spectrocolorimeter[J].Burns,2003,29(8):779-784.DOI: 10.1016/s0305-4179(03)00165-7.
    [26]
    LauJC,Li-TsangCW,ZhengYP.Application of tissue ultrasound palpation system (TUPS) in objective scar evaluation[J].Burns,2005,31(4):445-452.DOI: 10.1016/j.burns.2004.07.016.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (1161) PDF downloads(35) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return