【Learning Key Points】

1. A properly fitted pressure garment, custom-made according to the physician's instructions, can help prevent hypertrophic scar formation and joint contractures and promote scar maturation.
2. Wear the pressure garment for prolonged periods each day as instructed. If it is too tight or too loose, or if you experience numbness, discoloration, pain, skin breakdown, or other discomfort, take appropriate action immediately and seek professional assistance.
3. Maintain clean and moisturized skin, participate in rehabilitation as instructed, clean and care for the pressure garment properly, and attend regular follow-up appointments for assessment and adjustment.

I. Why Should You Wear a Pressure Garment?

Who should use a pressure garment?
Patients with second- or third-degree burns after wound healing who are at risk of developing hypertrophic scars or excessive scar formation may be advised by their physician to wear a pressure garment to help prevent scar proliferation and joint contractures.

During the proliferative phase of scar formation, continuous and appropriate pressure (generally 24–40 mmHg per cm²) may, over several months, influence the arrangement of collagen fibers within scar tissue. This may gradually make the scar softer and flatter and help promote scar maturation and stabilization. Pressure garment therapy may also help reduce scar redness, decrease local skin temperature, and improve localized edema.

II. When Should a Pressure Garment Be Worn?

When most of the wound has healed and the physician determines that pressure garment therapy is appropriate, a pressure garment specialist will take measurements and custom-make the garment. The garment will then be fitted and modified as necessary to ensure an appropriate fit and therapeutic pressure.

Follow the specialist's instructions regarding proper application and wearing techniques. If the garment becomes deformed, loses elasticity, or becomes too tight, it should be promptly adjusted or remade to maintain appropriate therapeutic pressure.

Continue wearing the pressure garment until the scar has matured, as determined by the physician.

III. How Long Should a Pressure Garment Be Worn?

The pressure garment should be worn throughout the day and night, except when bathing or performing skin care. Patients generally need to wear the garment for approximately 23 hours per day.

Each time the garment is removed, it should generally be off for no longer than 30 minutes.

Pressure garment therapy should generally continue for at least 12 months, or until the physician evaluates the scar and determines that the garment is no longer necessary.

IV. Precautions When Wearing a Pressure Garment

1. The pressure garment should fit properly and provide even pressure. Avoid excessive pressure or friction that may cause blisters or skin breakdown. If necessary, wear stockings or other appropriate protective clothing underneath as instructed.
2. A pressure garment that is too tight or too loose may not provide the intended therapeutic effect. If it is too tight, you may experience discomfort, numbness, purple or dark discoloration of the fingers or toes, or other circulation-related symptoms. If it is too loose, the garment may slip or fail to provide adequate pressure. Contact the garment provider for adjustment or remaking.
3. During pressure garment therapy, maintain an appropriate body weight. For growing children, the size of the pressure garment should be reassessed and adjusted as the child grows and develops.
4. The order in which the pressure garment is put on is important. Start from the distal part of the limb and work toward the proximal part. For the lower body, put on the foot garments before the pants. For the upper body, put on the gloves first, followed by the sleeves, and then the upper-body garment. Applying pressure from the distal to the proximal areas may help reduce edema. When resting in bed, elevate the affected extremities as much as possible to reduce peripheral edema.
5. If lotion has been applied before putting on the pressure garment, wait until the lotion has been completely absorbed and the skin surface is dry before putting on the garment. If there are small or scattered wounds, cover and protect them with appropriate dressings before wearing the garment.
6. Soft, absorbent cotton fabric or other appropriate protective material may be placed at areas where the garment seams come into contact with the skin, such as between the fingers or toes, to reduce friction, prevent skin breakdown, and prevent the fingers or toes from becoming contracted together.
7. When wearing a facial pressure garment, pay particular attention to areas containing cartilage, such as the nose and ears. Do not apply excessive pressure to these areas to prevent tissue compression or deformity.
8. Patients wearing pressure garments should avoid strenuous exercise. Areas such as the wrists, elbows, axillae, knees, and ankles are prone to friction and skin breakdown during movement or exercise. Remove the pressure garment during activities if instructed, and also remove it during showering and wound or scar care. Take the opportunity to gently move the affected joints as instructed during these periods.
9. During hot weather, children may have difficulty tolerating pressure garments. Keep them in an air-conditioned or well-ventilated environment as much as possible to reduce discomfort.
10. Continue regular skin cleansing and moisturizing while wearing the pressure garment. Appropriate moisturizers, such as baby oil or lanolin, may be used according to healthcare professional recommendations. Continue prescribed rehabilitation exercises.
11. If the patient feels uncomfortable while wearing the pressure garment, family members should provide continuous encouragement and emotional support and help the patient gradually adapt with patience and care.

V. Common Problems Associated With Burn Injuries

Patients may experience pain, itching, swelling, blisters, skin breakdown, wound inflammation, moisture, heat, discomfort, or restricted movement.

If blisters or skin breakdown occur, appropriate local wound care, cleansing, disinfection, and dressing may be required to promote healing. If the problem persists or cannot be adequately managed, consult the healthcare team or return for follow-up as soon as possible. The affected area should be appropriately treated before resuming pressure garment use.

VI. Possible Effects of Improper Pressure Garment Use

1. Poor circulation, resulting in swelling of the hands or feet, purple discoloration, numbness, or pain.
2. Skeletal or tissue deformities, such as flattening or deformation of the nose or hands, protrusion of the sternum, impaired growth or development of the limbs, or flexion deformities of the metacarpal area.
3. Skin problems, such as blisters, abrasions, redness, or itching.
4. Potential impairment of male fertility.

VII. Care and Maintenance of the Pressure Garment

1. Each patient should have at least two pressure garments so that they can be alternated for daily washing. Wearing the same garment continuously for an extended period may result in loss of elasticity and insufficient pressure, reducing its therapeutic effectiveness.
2. Washing: Hand-wash only. Soak and rinse in lukewarm water for 10–15 minutes. Do not scrub or machine-wash the garment. Use a mild or neutral detergent, such as mild soap or an appropriate mild dishwashing detergent. Avoid hot water, bleach, and harsh laundry detergents.
3. Drying: Wrap the garment in a towel and gently press or roll it to absorb excess water. Allow it to air-dry naturally in a well-ventilated area away from direct sunlight. Do not use a spin dryer, tumble dryer, or hair dryer, as excessive heat or mechanical force may cause deformation and loss of elasticity.
4. Avoid contact with oil, grease, or other substances that may contaminate the garment. If contamination occurs, wash the garment as soon as possible.
5. Regular clothing may be worn over the pressure garment.
6. Do not pull the garment excessively or catch it on sharp objects, as this may damage or tear the material.
7. Do not modify the pressure garment yourself. The garment's elasticity and therapeutic pressure should be reassessed approximately every 3 months, or according to the healthcare professional's recommendations.

VIII. Conclusion

After a second- or third-degree burn wound has healed, properly using a pressure garment according to the physician's instructions can help prevent hypertrophic scar formation, reduce joint contractures, and promote scar maturation.

The pressure garment should fit properly and be worn consistently for the prescribed duration. Maintaining appropriate skin care, rehabilitation, garment maintenance, and regular follow-up is important for achieving and maintaining the intended therapeutic effect.

If you experience pain, numbness, skin breakdown, discoloration, excessive pressure, or other discomfort, seek assistance from the healthcare team promptly to ensure safe and effective treatment.

IX. References

1. 蕭福尹. (2025). 術後的疤痕處理. 臨床醫學月刊. Advance online publication. https://doi.org/10.6666/ClinMed.202511/PP.0007
2. 鄭乃禎. (2025). 修復疤痕的非手術治療方法. 健康世界, (582), 36–38. https://www.airitilibrary.com/Article/Detail?DocID=16077059-N202508060003-00015
3. Gauglitz, G. G. (2025). Hypertrophic scarring and keloids following burn injuries. UpToDate. https://www.uptodate.com/contents/hypertrophic-scarring-and-keloids-following-burn-injuries