Abstract
The pneumatic compression system has demonstrated the potential to manage hypertrophic scar tissues using localized intermittent compressive forces. The underlying mechanism associated with these repeated, intermittent compressive forces is the remodeling capacity of collagen fibers of fibrous tissues in response to mechanical forces. Although intermittent compressive forces are clinically proven effective on managing hypertrophic scar, the optimal configurations of pressures and timing of intermittent compressive forces are largely unknown. In this study, we have developed a motor-driven ultrasound indentation system to apply programmable compressive forces and simultaneously assess soft tissue mechanical properties and responses. We further tested this system in various conditions with Institutional Review Board-approved protocols in human participants. The compressive force applied by the system was 40 mmHg on the skin of the forearm for 1 h with a frequency of 0.1 Hz. Soft tissue mechanical properties were assessed at three conditions, including (a) the forearm resting on the table with the wrist at a neutral position, (b) the forearm resting on the table with the wrist at 90° of extension or the maximal extension of the subject, and (c) forearm resting on the table with the hand holding a 1 kg weight. The effective Young’s modulus was calculated to characterize mechanical properties of forearm soft tissues. Before the 1 h intermittent compression treatment, effective Young’s modulus of conditions a, b, and c was 18.0, 11.3, and 16.8 kPa, respectively. After the treatment, the effective Young’s modulus of conditions a, b, and c was reduced by 13, 7, and 51 %, respectively. The results support our general hypothesis that intermittent compression therapy may modulate soft tissue properties (e.g. hypertrophic scar). Future work should investigate the long-term effect of intermittent compression therapy on modulating soft tissue properties in patients with hypertrophic scars.
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References
Atiyeh, B.S.: Nonsurgical management of hypertrophic scars: evidence-based therapies, standard practices, and emerging methods. Aesthetic Plast. Surg. 31, 468–492 (2007)
Aarabi, S., Longaker, M.T., Gurtner, G.C.: Hypertrophic scar formation following burns and trauma: new approaches to treatment. Plos Med. 4, 1464–1470 (2007)
Slemp, A.E., Kirschner, R.E.: Keloids and scars: a review of keloids and scars, their pathogenesis, risk factors, and management. Curr. Opin. Pediatr. 18, 396–402 (2006)
Reid, W.H., Evans, J.H., Naismith, R.S., Tully, A.E., Sherwin, S.: Hypertrophic scarring and pressure therapy. Burns 13, S29–S32 (1987)
Puzey, G.: The use of pressure garments on hypertrophic scars. J. Tissue Viability 12, 11–15 (2002)
Ward, R.S.: Pressure therapy for the control of hypertrophic scar formation after burn injury a history and review. J. Burn Care Rehabil. 12, 257–262 (1991)
Roques, C.: Massage applied to scars. Wound Repair Regeneration 10, 126–128 (2002)
Armstrong, D.G., Bharara, M., White, M., Lepow, B., Bhatnagar, S., Fisher, T., Kimbriel, H.R., Walters, J., Goshima, K.R., Hughes, J., Mills, J.L.: The impact and outcomes of establishing an integrated interdisciplinary surgical team to care for the diabetic foot. Diab. Metab. Res. Rev. 28, 514–518 (2012)
Holavanahalli, R.K., Helm, P.A., Parry, I.S., Dolezal, C.A., Greenhalgh, D.G.: Select practices in management and rehabilitation of burns: a survey report. J. Burn Care Res. 32, 210–223 (2011)
Johnson, R.M., Richard, R.: Partial-thickness burns: identification and management. Adv. Skin Wound Care 16, 178–187; quiz 188–179 (2003)
Serghiou, M., Cowan, A., Whitehead, C.: Rehabilitation after a burn injury. Clin. Plast. Surg. 36, 675–686 (2009)
Zaleska, M., Olszewski, W.L., Jain, P., Gogia, S., Rekha, A., Mishra, S., Durlik, M.: Pressures and timing of intermittent pneumatic compression devices for efficient tissue fluid and lymph flow in limbs with lymphedema. Lymphatic Res. Biol. 11, 227–232 (2013)
Shin, T.M., Bordeaux, J.S.: The role of massage in scar management: a literature review. Dermatol. Surg. Official Publ. Am. Soc. Dermatol. Surg. [et al.] 38, 414–423 (2012)
Zheng, Y.-P., Mak, A.F.-T.: Extraction of quasi-linear viscoelastic parameters for lower limb soft tissues from manual indentation experiment. J. Biomech. Eng. 121, 330–339 (1999)
Huang, Y.P., Zheng, Y.P., Leung, S.F.: Quasi-linear viscoelastic properties of fibrotic neck tissues obtained from ultrasound indentation tests in vivo. Clin. Biomech. 20, 145–154 (2005)
Zheng, Y.P., Huang, Y.P., Zhu, Y.P., Wong, M., He, J.F., Huang, Z.M.: Development of a foot scanner for assessing the mechanical properties of plantar soft tissues under different bodyweight loading in standing. Med. Eng. Phys. 34, 506–511 (2012)
Zhuge, C., Lung, C.W., Chen, D., Jan, Y.K.: Development of the feedback controlled indentation system for assessing risk of pressure ulcers. In: RESNA Annual Conference (Year)
Jan, Y.K., Lung, C.W., Cuaderes, E., Rong, D., Boyce, K.: Effect of viscoelastic properties of plantar soft tissues on plantar pressures at the first metatarsal head in diabetics with peripheral neuropathy. Physiol. Meas. 34, 53–66 (2013)
Zheng, Y.P., Choi, Y.K., Wong, K., Chan, S., Mak, A.F.T.: Biomechanical assessment of plantar foot tissue in diabetic patients using an ultrasound indentation system. Ultrasound Med. Biol. 26, 451–456 (2000)
Sun, J.H., Cheng, B.K., Zheng, Y.P., Huang, Y.P., Leung, J.Y., Cheing, G.L.: Changes in the thickness and stiffness of plantar soft tissues in people with diabetic peripheral neuropathy. Arch. Phys. Med. Rehabil. 92, 1484–1489 (2011)
Lung, C.W., Jan, Y.K.: Soft tissue biomechanics of diabetic foot ulcers. In: Ruiz, A.J.C., Mendoza, J.M.A. (eds.) Soft tissue: composition, mechanisms of injury and repair, pp. 1–32. Nova Science Publishers, Hauppauge (2012)
Hayes, W.C., Keer, L.M., Herrmann, G., Mockros, L.F.: A mathematical analysis for indentation tests of articular cartilage. J. Biomech. 5, 541–551 (1972)
Zheng, Y., Mak, A.F.: Effective elastic properties for lower limb soft tissues from manual indentation experiment. IEEE Trans. Rehabil. Eng. 7, 257–267 (1999)
Holmes, M.W., Tat, J., Keir, P.J.: Neuromechanical control of the forearm muscles during gripping with sudden flexion and extension wrist perturbations. Comput. Methods Biomech. Biomed. Eng. 18, 1826–1834 (2015)
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This study was supported by Ministry of Science and Technology, Taiwan (MOST 104-2221-E-468-020).
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Lung, CW., Cheng, TY., Li, YJ., Liau, BY., Jan, YK. (2017). Development of an Intermittent Pneumatic Compression System to Manage Soft Tissue Mechanical Properties. In: Duffy, V., Lightner, N. (eds) Advances in Human Factors and Ergonomics in Healthcare. Advances in Intelligent Systems and Computing, vol 482. Springer, Cham. https://doi.org/10.1007/978-3-319-41652-6_30
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DOI: https://doi.org/10.1007/978-3-319-41652-6_30
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