K. A Wallis’s research while affiliated with Royal Adelaide Hospital and other places

With the introduction of silicone gel in 1981, the emphasis in the treatment of burn scar management has changed from pressure to the use of contact media. A range of 'contact media' has been introduced, allowing for therapy to be individualized to the patient and the scar. Over the last few years, the introduction of 'the adhesive technique' has allowed for earlier therapy with the aim of preventing or minimizing scar hypertrophy with better short- and long-term cosmetic results. The mode of action of 'contact media' is discussed, with a suggested hypothesis and further lines of investigation.

A new technique for split skin graft fixation using ‘hypafixy’ adhesive dressing is described. Ninety-three patients with bums involving < 20% body surface area grafted at the adelaide children's hospital during february 1985-may 1987 were reviewed. Comparisons were made between the results of standard fixation and hypafix methods. The hypafix technique showed itself to be simple and reliable, affording considerable versatility and allowing early mobilisation without splintage or sedation. The adhesive is readily loosened with ungvita ointment allowing the dressing to be removed painlessly. In this study its use has shortened both the length of inpalient stay and outpatient follow-up in the scar management programme.

A range of materials is now available for use in a burn scar management programme. The use of these materials is detailed and suggestions are made based upon the experience gained from close clinical observation of children treated over a 7-year period at the Adelaide Children's Hospital Burn Clinic. Lightweight pressure garments are still needed to keep these various media in contact but are not included in the discussion.

A new method of treatment for burn scar management is outlined using silicone gel sheets (Spenco Corporation MD-3071). The method has been applied to 42 patients with burns of varying degree and maturity. The results have been successful in all cases. The mode of action of the gel is unknown, but it does not rely on pressure. The method can easily be tailored to the individual needs of the scar and the patient. Individual initiative and a flexible approach to its use are advocated.