The investigators developed a portable pressure measuring device using silicon piezoresistive
pressure sensors. As PicoPress® is the most accurate (i.e., lowest variation and error)
manometric sensor for pressure measurement, the investigators used it to compare and examine
the accuracy of the proposed device regarding in vitro pressure measurements. The purpose of
this study was to determine the effectiveness of pressure garment therapy using proposed
device with objective data obtained with a randomized within wound comparison. Pressure
measurements were acquired through a readout circuit consisting of an analog-to-digital
converter, a microprocessor, and a Bluetooth transmission module for wireless data
transmission to an external device. The mean pressure values measured by the sensors were
compared to those obtained from PicoPress®. This was a double-blinded, randomized, controlled
trial of patients with hypertrophic scars. In the pressure monitoring group, garment
pressures were monitored using the portable pressure measuring device, and the compression
garment was adjusted so that the pressure was maintained at the therapeutic range of 15 - 25
mmHg. In the control group, non-surgical standard treatment of burn scars except for pressure
monitoring was performed in the same manner. To evaluate the effect of a pressure monitoring
device, the investigators compared the skin test results (thickness, melanin, erythema, TEWL,
and skin elasticity levels) between the two groups, from baseline measures immediately before
the treatment and measures immediately after 2 months. The participants were made comfortable
and acclimatized to room conditions. Room temperature was maintained at 20-25'C and relative
humidity at 40-50 %. In the supine position, skin properties were measured. The thickness was
measured with a ultrasonic wave equipment (128 BW1 Medison, Korea). Mexameter® (MX18,
Courage-Khazaka Electronics GmbH, Germany) was used to measure melanin levels and the
severity of erythema. The higher values indicating a darker and redder skin. Transepidermal
water loss (TEWL) was measured with a Tewameter® (Courage-Khazaka Electronic GmbH, Germany),
which is used for evaluating water evaporation. Elasticity was measured using Cutometer SEM
580® (Courage-Khazaka Electronic GmbH, Cologne, Germany), which applies negative pressure
(450 mbar) on the skin. The numeric values (mm) of the skin's distortion is presented as the
elasticity. Two seconds of negative pressure of 450 mbar is followed by 2 s of recess, and
this consists of a complete cycle. Three measurement cycles were conducted, and the average
values were obtained. The parameters consist of the following biomechanical skin properties:
distenstibility, elasticity, and viscoelasticity. Distensibility means the length of total
displacement from initial postion at maximum negative pressure. Gross elasticity means the
ability of the skin to return to its initial position following displacement. Biologic
elasticity means the ratio of immediate retraction to total displacement. Viscoelasticity
means the ratio of delayed distension of immediate distension. Outcome measurements and data
analyses were performed by a trained and blinded outcome assessor who was not involved in the
intervention. Possible complications (pain, ecchymosis, pain, skin abrasion, and swelling)
were observed.