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Record W2922010906 · doi:10.1093/jbcr/irz013.101

99 Are Custom Fabricated Pressure Garments Applying Adequate Pressure?

2019· article· en· W2922010906 on OpenAlexaff
Bernadette Nedelec, Ana de Oliveira, Valérie Calva, M Couture, Chantal Poulin, Léo LaSalle, José A. Correa

Bibliographic record

VenueJournal of Burn Care & Research · 2019
Typearticle
Languageen
FieldMedicine
TopicBody Contouring and Surgery
Canadian institutionsMcGill UniversityCentre Hospitalier de l’Université de MontréalMcGill University Health Centre
Fundersnot available
KeywordsMedicineWilcoxon signed-rank testBlood pressureSurgeryBiomedical engineeringInternal medicineMann–Whitney U test

Abstract

fetched live from OpenAlex

Custom fabricated pressure garments (PGs) are commonly used to treat hypertrophic scars (HSc) after a burn injury. However, there is minimal scientific evidence quantifying the pressure applied after standard measurement and fitting techniques. In addition, the pressure likely decreases with time as the PGs are worn, but this has not been systematically documented. A pressure-sensing device validated specifically for this type of evaluation is now available. The aim of this study was to quantify the pressure applied to HSc and normal skin (NS) by custom fabricated PGs and the extent to which the pressure varies with time. Burn survivors whose HSc (diagnosed using the Cutometer and high-frequency ultrasound) was treated with custom fabricated PGs were recruited after signing an informed consent. A trained fitter, blinded to the study locations and results, took the garment measures. Once the PGs arrived and were fitted, baseline measures of the applied pressure, at standardized HSc and NS sites, were determined. Pressure readings were repeated at 1, 2 and 3 months to determine the applied pressure at the specific study locations. Participants also maintained treatment diaries during the study period. The mean mmHg pressure applied at baseline was 15.3 (SD 10.4) at the HSc and 13.4 (SD 11.9) at the NS sites. Wilcoxon Signed Rank Test revealed a significant reduction in pressure during the first month at both sites (p<0.001 HSc; p<0.001 NS). A multivariable linear regression model, adjusting for garment type and repeated measures, revealed further reduction at the HSc site between 1 and 2 months (p=0.047). By 3 months, the mean pressure had reduced to 9.9 (SD 6.7) and 9.2 (SD 7.2) mmHg at the HSc and NS sites respectively. At each time point the mean pressure applied was higher at the HSc compared to NS but was significantly different only at 1 month (p=0.005). PGs were worn on average 16.3 hrs/day 3.8 days/week (per garment). A systematic review and meta-analysis determined that PGs applying 15–25 mmHg pressure showed significant HSc improvement when compared to low/no pressure. However, immediately after fitting, the average pressure of newly fabricated custom PGs was at the bottom of the recommended range and by 1 month was significantly below. Clinicians are likely underestimating the therapeutic pressure dosage that is required for custom fabricated PGs and need to be aware that there is significant pressure loss within the first 2 months. To optimize PG prescription, reliable pressure assessment is recommended.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.664
Threshold uncertainty score0.750

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.050
GPT teacher head0.359
Teacher spread0.309 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2019
Admission routes1
Has abstractyes

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