Enhancing quality of pressure therapy services
Actual training for burn rehabilitation professionals in Central America officially began on October 5, 2013. For this year, the focus was on making pressure garment vest for women, the particularity of the vest being that it is perfectly adapted to women’s anatomy, thus ensuring better fit and comfort. But because of this, it is also the most difficult type of garment to make.
Precision of measurement: Multiply the points of measurements to enhance precision in terms of size and fit.
The Sunshine team led participants through the first step for making pressure garments: measurement. Precise “anatomical landmarks” must be identified on the body, which is then measured in all possible lengths, widths and circumferences. Therapists are quite familiar with these landmarks, but for seamstresses, it takes some time to remember each landmark’s name and position. And because there are more measures, this method also takes more time than the original method used by the seamstresses, but in the end it ensures better accuracy.
Adjustment of pressure: Use specific calculations to precisely add or reduce pressure given by the garment, depending on the scar status of the patient.
The second step is dreaded by both therapists and seamstresses alike: making the pattern. The idea of a pressure garment is to create pressure on scars and to do so, original measurements must be “shrunk” so that the garment fit more tightly. The seamstresses must first precisely calculate the shrinkage of the garment through various formulas, depending on how much pressure is required on the scar. Although necessary, this step can be intimidating, especially if you don’t like math!
Tri-dimensional pattern: Special pattern techniques to create tri-dimensional garments that offer better fit and better coverage over the scars.
With their new numbers in hand, the seamstresses can then proceed to drawing the pattern of the garment. For the experienced therapist of Sunshine Foundation, drawing the pattern for a woman’s vest might take 30 minutes but for the participants, it took two full days to learn all the steps of drawing the pattern. The reason why the process is so complex is that instead of making a “flat” garment with front and back pieces sewn together, we use many pieces to create a “tri-dimensional” garment that will fit better and provide better coverage on the scars.
The final step is sewing, and this is something the seamstresses are expert at! But there are still precise steps to follow to make sure that the garment is sewn correctly and fits well. The seamstress from Sunshine Foundation guided participants through the process, sharing tricks of the trade along the way.
Involvement of the therapist in the process: Ensure that burn rehabilitation knowledge is at the base of pressure therapy.
We can’t emphasize enough how pressure garments are not just “tight fitting clothes” but are instead an integral part of the rehabilitation program of the burn survivor. As such, knowledge about burn rehabilitation (how burn scars evolve and mature, their impact on physical functions, etc.) is crucial when making the garment: it’s the therapist that has the knowledge and skills to determine what kind of garment the patient needs, what level of pressure is adequate, etc. But in Central America, this heavy responsibility is almost entirely shouldered by the seamstress. That is why starting in 2012, we have expanded the training program to involve therapists who work as a team with the seamstresses throughout the whole training process, learning together the measurement and pattern-making steps. Therapists not only offer support to the seamstresses during the training, but this support also continues after they return to their country and face the difficult challenge of mastering and implementing the new techniques learned.
This kind of training is both physically and mentally demanding on participants because of the time involved, but also because of the amount of knowledge that must be absorbed. It is also demanding because it means that participants must leave aside their “old familiar” way of doing things and adopt “new unfamiliar” techniques. But participants have consistently told us that the effort is worth it and when they succeed in finishing their first garment, the sense of pride and accomplishment is their immediate reward.