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Dissertation - JYK.pdf (5.62 MB)

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Mechanical Regulation of Burn Wound Scarring

Kim, Jayne Y
http://rave.ohiolink.edu/etdc/view?acc_num=osu1437478345

Abstract Details

2015, Doctor of Philosophy, Ohio State University, Biomedical Engineering.
Hypertrophic scars (HTS) are common following cutaneous injuries with up to 91% of burn wounds resulting in HTS and can lead to significant loss of mobility and function for patients. HTS may also be complicated by erythema, hyperpigmentation, pruritus, ulceration, burning and secondary infection, further reducing the quality of life for patients. Although pressure garment therapy (PGT) has been used clinically for many decades, there remain some issues that need to be further investigated: 1) creation of reproducible, uniform, full-thickness burn wounds to reduce variability in observed results that occur with burn depth, 2) controversy remaining regarding efficacy, 3) loss of tension and ability to deliver adequate pressure by garments, 4) validation of appropriate HTS model in large animal and 5) determination of optimal time for pressure application. To investigate the issue with uniform wound creation, a custom burn device was developed with an electrically heated burn stylus and a temperature control feedback loop via an electronic microstat and compared to a standard burner. The custom burn device was able to continually heat the burn stylus and actively control pressure and temperature, allowing for more rapid and reproducible burn wounds in comparison to the standard burner. With the creation of uniform starting injury with the custom burner, the efficacy of PGT was then evaluated in a female, Red Duroc pig (FRDP) burn model. PGT was effective in reducing scar contraction and improving biomechanics compared to control scars. However, these improvements were modest. Therefore, we sought to enhance the efficacy of PGT by optimizing the garment fabrication design for better pressure delivery. In order to design more effective compression garments, a study was performed to investigate the mechanical and structural properties of pressure garment fabrics in order to design garments which deliver the most consistent pressure levels and maintain good durability after repeated wear and laundering. The results suggest Powernet (a 9:1 nylon-Spandex composite fabric) as being more suitable than moleskin fabric for engineering compression garments. Additionally, burn and dermatome models for hypertrophic scarring were developed and investigated. The results suggest that burn wounds provide a scar model in FRDPs that most closely resemble hypertrophic scarring in humans. Using this knowledge, the efficacy of pressure garments fabricated from Powernet fabric was analyzed on a FRDP burn + split-thickness model. We found that early application (day 7 post-injury) may be more beneficial in the treatment of scars than late application (day 35 post-injury).
Heather Powell, PhD (Advisor)
Douglas Kniss, PhD (Committee Member)
Alan Litsky, MD, ScD (Committee Member)
J. Kevin Bailey, MD (Committee Member)
William Notz, PhD (Committee Member)
130 p.
Biomedical Engineering

Recommended Citations

Citations

  • Kim, J. Y. (2015). Mechanical Regulation of Burn Wound Scarring [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1437478345

    APA Style (7th edition)

  • Kim, Jayne. Mechanical Regulation of Burn Wound Scarring. 2015. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1437478345.

    MLA Style (8th edition)

  • Kim, Jayne. "Mechanical Regulation of Burn Wound Scarring." Doctoral dissertation, Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1437478345

    Chicago Manual of Style (17th edition)

osu1437478345
359
© 2015, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.