Citation: Journal of Burn Care & Research. 38(1):28-35, 2017 Jan/Feb.Journal: Journal of burn care & research : official publication of the American Burn Association.Published: 2017ISSN: 1559-047X.Full author list: Carney BC; Liu Z; Alkhalil A; Travis TE; Ramella-Roman J; Moffatt LT; Shupp JW.UI/PMID: 28009695.Subject(s): Animals | *Cicatrix, Hypertrophic/me [Metabolism] | Cicatrix, Hypertrophic/pa [Pathology] | *Cicatrix, Hypertrophic/th [Therapy] | Disease Models, Animal | *Elastin/me [Metabolism] | Male | Pliability | *Pressure | Swine | Wounds, Penetrating/co [Complications] | Wounds, Penetrating/pa [Pathology] | *Wounds, Penetrating/th [Therapy]Institution(s): MedStar Washington Hospital Center | MedStar Health Research InstituteDepartment(s): Surgery/Burn ServicesActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1097/BCR.0000000000000413 (Click here)Abbreviated citation: J Burn Care Res. 38(1):28-35, 2017 Jan/Feb.Local Holdings: Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present.Abstract: Beneficial effects of pressure therapy for hypertrophic scars have been reported, but the mechanisms of action are not fully understood. This study evaluated elastin and its contribution to scar pliability. The relationship between changes in Vancouver Scar Scale (VSS) scores of pressure-treated scars and differential regulation of elastin was assessed. Hypertrophic scars were created and assessed weekly using VSS and biopsy procurement. Pressure treatment began on day 70 postinjury. Treated scars were compared with untreated shams. Treatment lasted 2 weeks, through day 84, and scars were assessed weekly through day 126. Transcript and protein levels of elastin were quantified. Pressure treatment resulted in lower VSS scores compared with sham-treated scars. Pliability (VSSP) was a key contributor to this difference. At day 70 pretreatment, VSSP = 2. Without treatment, sham-treated scars became less pliable, while pressure-treated scars became more pliable. The percentage of elastin in scars at day 70 was higher than in uninjured skin. Following treatment, the percentage of elastin increased and continued to increase through day 126. Untreated sham scars did not show a similar increase. Quantification of Verhoeff-Van Gieson staining corroborated the findings and immunofluorescence revealed the alignment of elastin fibers. Pressure treatment results in increased protein level expression of elastin compared with sham-untreated scars. These findings further characterize the extracellular matrix's response to the application of pressure as a scar treatment, which will contribute to the refinement of rehabilitation practices and ultimately improvements in functional and psychosocial outcomes for patients.