Michael Serghiou es el conferencista invitado en esta oportunidad. Michael graduó como terapeuta ocupacional de la Universidad de Kansas y tiene un MBA de la Universidad de Columbia Southern. Tiene más de 25 años de experiencia en el manejo de quemaduras y se ha especializado en el área de rehabilitación. Ha sido autor de muchos capítulos de libros y manuscritos relacionados con la rehabilitación del paciente quemado. Trabajó por más de 15 años en el Hospital Shriners de Galveston Texas y actualmente se desempeña como Especialista de Cuidado Clínico en la organización BMS. Es miembro del comité de rehabilitación de la Asociación Americana de Quemaduras (ABA) y el representante regional de Norteamérica para la Sociedad Internacional de Lesiones por Quemaduras (ISBI).
Hola. Hello? Hello, Allah. Gina, Uh, was perfect. A I'm doing good. So I suppose sarcoma stars will be any Took over as fast. Gracias. Yes. Oh, man. I saw no Graziano. Gracia proximo. You know, you say no one? No, because no. Where? No, no, Nobody will. No, no. Hey, hey. Let me let me get the lecture going. If Gina can see Yeah, okay. That's it. Okay. Yeah. Wait. Do this now. Okay? No, that's zero. Okay, not because there's a lot of people. Oh, I love you. No. These two presentation is open. All right, So can you see the presentation? No. You selected another. Hold on one second. Uh, something? Yeah. Stop sharing. Yes, I'm try again. Go. Okay, now it should be all right. Okay. You can see now, right? Yes. It's the stone. A update. His intelligence here. Mhm along. Can you see? Yes. Okay. Yeah. Okay. Can you put it in presentation mode? It is in presentation mode now. No. Um, no. Well, we can see what is the next slide like Oh, all right, let me see. How do you do that is down here, right? E, I don't want you to see the next slide? Yes, it is. What is happening when you go back? Or how did you get out off their How do I get out of here? Uh huh. Yes, you are there. Can you see it now? Well, not in presentation mode. We can see it in the regular people. I mean the Yeah, I have to when I click here. No. Huh? Compare 10. Does You can see the other slide, right? Yes. You click there. Okay, Uh and you see the other slide now or not way are still seeing it in the power point regular mode. I'm not I'm not understanding. What we see is like the first slide, but on the left side, we see Yeah, Slide. It is not in presentation mode. Well, on my on my computer, I having a presentation mode. So that Z that's the thing. Let's see. What about release that? No. Oh, um you know what? Let me if I disconnect Hollande, can you see me still, right? Yes, Yes. Okay. Okay. Yeah. So it is the same thing, but you know Saraki Iniesta party introduction That solution a and algunas estas. How do I get rid of the next slide. I haven't never seen this before. I haven't seen this before. Mhm. Hi, presenters view that one. Yeah. Yeah. Okay. Let me connect to my big screen because I lost my big screen now. Okay, um, hold on. I hope that it connects because I can see better. Mm. They connect. Hold on, you will. Come on. Mhm. You're still okay, right? Yes. He didn't, uh let me see if you call next. Now. Yeah. Janita Hospital Hospital. Alina Los Ninos Hospital National de Ninos, The hospital national Nina Cld El Nino. Seldom Panama Missing our enemies. Uh huh. Yeah. No viscera. And don't they in lonely, etc. A Santa poll Mhm that the power tip. I just go in and tell me Pucillo Saudi for hospital, sir. How old you were. That's which almost perfected for money. Uh huh. E lost my screen. Me? I don't know what happened, but I do it from the smaller one. Okay. Mhm. Do you want to show very quickly, toe Gina. But yeah. And you see Gina. So we're gonna talk about scar management. Okay. Some theory about Hypertrophic Scar versus Kilo, its car. What is my tour in my tour on pictures, traffic. Uh, then we're going to talk about some history about pressure, pressure, garments. Why? We use what we use for pressure. There's some research. Oh, this one is not showing now. We got a problem. How long, guys? Uh, I don't know why my screen is not showing passengers. All right, so let me I need thio. Uh, I don't know why it's not letting me next to my screen, because this one now is no showing my whole slides. We can see the whole slide. But you needed to see it too. Why is that thing down here? What is that one? That a go c is blocking some of my slides. Uh, let me, uh Do you want to reconnect or what? Yeah, let me connect their quick. Okay, go, go. Hold on one second. Oh, there you go. I got it. Okay, Perfect. All right, let me see. Let me see now. Is that good for you? It shows the next light again. No, it is not. But it is showing the regular power point where you have on the left side all the all the slides. So it is not in presentation mode that it's not again. So let me go back here. What did we do before you click again on the alcohol? Lazio lays order. Uh huh. Mm. How about now? No. Yes, Yes. Got it. Okay. Perfect. So we're gonna talk about some some research, Gina, about Latino sides. And my my oh, fiber. Plus, we're gonna talk about the blast law for pressure, the pressure, you know later. You know, convex versus, uh, you know. You know. Okay. Yeah. E think there's a video here if you place to show insert inside. I think you've seen some of these are people joining. So we go back. Well, I haven't, um, year yet, so we are still in three of us. All right, so then we're gonna talk about silicon gel sheets. Okay? The theory behind how they work. Hydration, oxygen, tension, occlusion temperature. It's gonna be a little difficult to translate, I think, Gina, But we do the best we can way that we owe about hydration. The main thing about silicon, the main points about silicon is hydration. Eyes, oxygen, tension, increasing temperature, eyes. How silicon works. Yes. Come on. Okay. And that's some silicon and in some research. Okay. How? Silicon works inside the facial, the pressure white masks. Yeah, I'll explain, but basically laser silicon inside the transparent face mask, uh, increases and maintains the overtime. Okay, Right. So that's about profusion. Maintains decreased perfusion over time. So when you have Silicon Mosque mhm with you vics and silicon together combination, it increases the blood flow, and the blood fall remains decrease over time. Okay. You understand, team Miguelito, I need to go life. Okay, let's go. I let me go back to the beginning. Yes. And this will take about an hour. Sounds great with translation, so let's go. Okay, so let me put it that I'm gonna do it right now, Okay? When I started at all bienvenidos uh, just a masaki list, ALS uh, strong confidence system. Beetle is something con Gina, Medium massage, Qantas Person aside, securing mama's Desperado. Who knows me know Ticos a Caymus Hint. Uh, Bonanno's otras zonas eyes representation. Yeah. No, no. Minutos system was common sense way. We're gonna wait a couple of minutes. Michael, Um, so more people can join us a couple of minutes. We can start, You know, Sanjay Gandhi menus grasses participar e boy Jana knows part of the story. Most common Sando called representation bienvenidos on a scale And Uganda when I started at all the menus and Pakistan jugando a party minutos mas para que maskin ccpoa funeral a presentation and the convincer asi que minutos experiment part of politicos. It's common sense. When I started toes, There's some of us Don't you know Thomas E came? I hate to say own a presentation to the COMESA. I think I know. You know the story was coming family and Benito one Mhm, Dennis, you know, high purple. Mhm. Yeah. One. The T courts didn't do very well, amigo, because, okay, many people that we have right now, you know? Yes. 14. So far, 14 connections. I'm not sure how many people were connection. Okay, Yes. Uh, okay. So if you want, we can start on for sure. More people are gonna be joining us soon. Which is grasses Atos. For what? Sarah numbers Liliana Gamma Metra sa, unit director of the program as the organization Americans for fast make passes Soon organizations in any more lucre history kind Norfolk, Virginia. Instruments in principle. Islamic, uh, America, Uh, a uh, boy, I think it'll be in the news and it's opportunity. Jack and in Moscow, Complete system in the towel on Michael Surgeon Michael Several Okamoto Pelota aka Personal. The University of Kansas It in the n b. A. The University of Columbia, South ER Terry Maseratis Inquiry of experience in and Money Kimura's is especially Saban Ilaria Rehabilitation. I set out toward the MACHOs capital of the leaders in manuscript toes Lassana Scola relatives in passing the camel. Uh, how hopeful Magic is a national hospital. Shriners and Galveston, Texas Elector Romanticism Pennock Mr. Calista, We are clinical and organization. The M s A is mayoral committee Rehabilitation Association American Eric Madura A Be a yes, represent that the regional the North America Carol Associate International Relations Pot Kimura's is Michael Machismo. Gracias. Por estar aqui Tenemos community Gina Gina para estar a protocol personal in Costa Rica. A hospital National de Ninos in San Jose, Costa Rica A process or a university in Santa Paula Come in Costa Rica, a genius. But you are gonna traction in the conferencia a genital mean which is gracias TV NVIDIA Michael Machismo Porto Tiempo Thank you so much for your time on did you can start. Thanks. Okay. Well, thank you, Bibiana. Thank you very much. Everybody special. Thank you. To Gina, who is gonna help translate on maybe teach us a few things today. As she is one of the the best occupational therapists in in Central America that I have worked with in the past. I'm sure on the cold there are many friends. So hello to everybody. And for those of you who I knew to these lectures, we welcome you and we hope to collaborate with you in the future. So they were going to discuss scar management For those of you who attended previous sessions with Can you give a translation? Yes. Sorry. Way when I started my call. No Solu Atos Cordell Mente. Mm. Salvador Los amigos. This Central America is what America Kistane is. Which analysts momento Charla e s Alba sorority tas who presentation acerca del monaco? Uh, a party. Different technical studio e methodology s k therapeutic aumentaron compra annual scientific Oh, it nos muestra but not always toe in le presentation conversation. So? So for for those of you who are new to these sessions, we have previously presented positioning and splitting. And today we're gonna talk about scar management. Notre Sec in the Russian chemist in Edo, Michelangelo a circle position aumento in the past in disoriented the Madurese Oy blah, blah blah a circle money ho The last six koalas and Picasso Elastica, Trees ASIO. So scar management is something very, very important. That therapist and the current rehabilitation team in general will do when, uh, wounds have closed. L money hold the process. Jessica drizzle is soon expected. More important, Pareto Keep o que trabaja close pacientes oriented Madura una vez kill appeal esta completamente, sirrah. So all of us have some kind off experience in managing scars on. And our experiences may be different from each other, and our techniques may be different from each other. Toast and a more different technicals. Different experiences. A different manera the co momani Hamas. But that is the process of the secularization industries. Passengers in Corona loss. But he says he lost a baby even though we may have different techniques to manage scars, we all have the same goal. And the goal is to depress hypertrophic scars and reverse contractions. Um, those and most in terms of different technical spiral. Optus. El mismo. Yes, These be New Year. L crazy me. And prepare trophic o Mara a disorder now, Elastica Trees. So it's very important in this lecture, uh, toe understand wound closure and the scar maturation process espera in esta Charla para Michael is be important. Take it doesn't. In the most coalesce el tipo the evolution and Elastica trees you now is getting the most relation in lapel vera Deakin pss the process of secularization para el Sierra commuter. So there are different kinds off scars, different types of scars. And and and it's important to understand that when wounds closed they develop scar existing, different steeples. The secretaries, it's tells people the secretaries in personal Sarah Johnson una vez cal appeal a cerrado Claritas tazara the scars. We want to see that the completion of rehabilitation at the flat scars that are soft and allow movement. Look, Brusca, Moses. Kenya's processes catherization lapel, paternalistic at risk, say a low mass planet, possibly Lomas flexibly, possibly copper metal momento a functional in a person. So as the wounds closed and develop scar, this burn scar will continue to write to raise to become hypertrophic. If we don't intervene. Assess In rehabilitation, the most tender CO now is last lesions and serve a lapel a cerrado Elastica Trees in Pisa trabajar continue era secrecy Mentos organizations, you know. So it was not almost gone. Last Technicals getting Gamow Salomon So hypertrophic scar is the scar that raises and remains within the original boundaries off the wound You know, there's two steeples Jessica trees is logic attrition, potro FICA classic attrition Potro FICA uh, Kara Sea is saying incremental doses Arroyo verde Initial mental relation uh, for Peru Nelissen, Porky Madura Pero respect laws borders Varda de Larrea Committal the city of the CIA These these fresh hypertrophic scars are very painful and very itchy is the tip Elastica, Trees a Cioni petro FICA henna Rinella persona Mutko Preto comments on Picasso E mutual or and they will continue to change to proliferate. Uh, if we don't do anything to them e change and rice and be painful. E s stem s attraction is the Lord e the burrito banas excessive us Even a service organize house Even a certain official is the money hearts, you know Los Alamos ballot is the momento they later mention in Asia So what we need to understand about the hypertrophic scars. Uh, the collagen within the tissues becomes disorganized, and it's not in a parallel fashion, but instead of party, becomes like a spaghetti like collagen and continues to be produced. There's other abundance of collagen that is disorganized. That makes the hypertrophic scar. In terms of lassic, Atriss, hypertrophic asada, a party, the fear of the color he knows. Organized on the monitor Parallel I planet seen. Okay, save uncommon Trela. Sandri means, you know, lks. Come over spaghetti. And this is Allison December that esta manera will tha with you not petro fia crazy me interest or the Now there's a fever is a Latino locate. But I guess Arredondo is the political crisis here. So the next type of scar is called the key Lloyd Scar. You'll see entity people. The secretary's ASEAN zone. Elastica trees is the tip of colloids. This car is defined as the scar that grows outside the original boundary of the wound. So the wound, maybe the small, but the scar continues to grows to grow over the original size in to assist the people, the trees, the people colloids a assay hotel a characteristic a crazy poor fuera del markinor the limited Della s your initial? Yes, it does. Look, a common photography is a tang Grand Nutanix ahead of time. Crecido is organizing cola. This this, uh, kill Lloyd Scars are very difficult to manage in rehabilitation and usually they require the intervention off the doctor. We do surgeries or injections before we can do some kind of therapy. Mm. Paranoia. So true. Centralization is that Politika trees is on the move. Difficile, Manny E Henry realmente necessity. And you know what the heck? Hiccup or Manolos? Medicos barrack arrogance. It s a Ramos coloration is a promotion. Lugosi, Pomona, Soto's in Terminator. Um, and religious young Connecticut Christmas characteristic it Traffic in Otranto Colloids forecast McComas official is the money. So the hypertrophic scars, uh, at the beginning when they closed When the wound closes are immature, They are raised their red and they're very rigid. They're very hard. Last psychiatrists hypertrophic a initial mente. Let's consider a machine. Madura is the city complainants Stress characteristic a Sandra here. Uh, is the cereal Come on. The Messiah Intentional to hell. Is that the Colorado Mara esta the Coronado Presidio lt here. When the scars are immature, we the therapies can manipulate them and with the different techniques we're gonna discuss and making flood and treat them with the techniques we have Cuando nos otras Brenda most Lysistrata areas therapeutic aslo grandma sentences unisex trees Madura, Syria plan a kid's flaccid like noise Dolorosa ik no una come alteration the most sensational. Any city here and and we therapies have a lot of time to manipulate them. My tour scars because my poor scars will be anywhere from, uh, about one year and sometimes almost two years. They remain in mature. Okay, so this el Tiempo the money hold the award. A head start in El Caso No Soto center Apia during help Romero El Segundo, and case Cuando Polamalu cambios in Elastica trees. And then you know this this parameters I'm giving you 1 to 2 years are just just general parameters because every person will scarred differently. Okay, Okay, parameters. Tancredo's a treasonous, but then on the formal center appear in the room money hone our die. Who is the most consider characteristic properties. The cop persona que please and a barrier is the para Metro General Casita. So if you If you can imagine the spectrum of colors from red to white, the immature scar will be very red. Then we'll become purple, then will become pink. And then we'll have to change color to towards the white color as the scar mature. Okay, the Muslim in our camo less calorie color pasando this Deltona Rojo told us. Less intense. Er 40 Rojo a style Morocco Purpura logo. Los Colorados house Ill ago. Lost Ono's Blanco's does the same. Tonally, a entry master canister is a tonal Blanco. Classical bombs McComas Malouda Marla versus last stand Massa Celestine Aaliyah Row has support for Osama scales Elastica Trees que esta in Madura active As the scar mature, they become more pale, more pliable, more plastic and flatter. They become a decrease in height Condos most logical Madura arms away reflexively Um plan a, uh no, the sword in our then it's a crazy me in tow. Lto McComas mobili facil the trabajar. So the fresh cars are very painful. But as the scar, my tours and change will be less painful. Okay, let's stick a tree system maintaining a characteristic a okay in America kissed in LA condition they in Madras. But I said Psychiatrists Mazzola, Rosa's Lasek actresses Maduro, please know an attorney advertiser presents. Yeah, look! So when the When the wounds remain open for about 14 days, most likely if they close around two weeks, they will not develop hypertrophic scars. Okay, Cuando Nemo's uh, serious. Maria's resolution is L A p l men knows they lost Catterson. Yes, CB uh Mendoza Los Catorce ideas esperamos were supposed okay. No wage aware crazy mentors or the novelas, the lapel or pork Corrado anti the team. Pero si could and posterity or I so scatter, say yes in terms of those photos are must have our homo style laughing me now. Incidentally, 2% possibly are probably the case say they would not seek a treasonous juniper profit. Very good. So yeah, they said 78% prevalence off developing hypertrophic scar like Gina just said So it's very important to understand the wound closure because the longer the wound remains open, the more the scar the hypertrophic scar will come into play. Okay, so most contender is aware in the tuberculosis various forms pacientes one off way el momento el cases role appeal. There's the actual Allessio. Porky Madura? Asked a Casero. Total mental appeal for K says Unica TiVo Paris our Qantas. Zia started Ansara. Yes, you know. So just almost in Caiaphas esta is a process of the Zika trees. Orsino survives already are secretaries. So here is an example of a of an immature hypertrophic scar that is red raised in region. It starts photography assistant d minus on him plus the Zika tresses. Hypertrophic assumes there's observe Anistan, Conan Verrengia, Istana Live assistant. The Colorado Hose on a poor, poor Isabella Isabella Latin's Ian Khama talent is that he kissed a crescendo. Jordana, here is this car that is mature. Now it's become or more white mawr. Lana. More elastic. Yes, tha m a Hannan Westra camo Elastica Trees esta Janine Parry, Odo Maduro. And on the star Blanca flexibly. Unanimous esta mui scenario Renzi Advertiser camo. McComas facile the money. Hari. There really is a lot more events. So today we're gonna talk about some specific things. We're doing this car management that include pressure, governments, inserts, and specifically, silicon splitting massage and other modalities. Okay. My cholera bobble are different. Amalia is there were the hell a zika trees for him flow in Certo. So Ferriola So Masahiro Silicone intro trees. Part of what we do is therapist includes the positioning, the range of motion, the exercise and wound care and those pretty much all of us do. We're going to discuss these other things I mentioned a moment ago. Okay. Influences, place comments, instrument initial problems. Attend a local position. Aumento el Monaco Telecom moment Talked with placebos. HRC CEO suggested aumento equally are barred a requirement loss. Benda has process with the L A area in Asia. So let's start with pressure garments. Um, the first reports on pressure Garment came all the way from the 16th century. Okay, uh, Baron Salar del A therapy oppression or the last like Chris Ferraro. Presto Therapy. Uh, l a premiere A referential city n f the loser The presto therapy A is so rails cercano and Al Cielo. These essays those days in the 16th century, they will wrap the wounds with banana leaves and wrap them with clothes. Uh, no. Bandages were existing them, so they will wrap them with some kind of cloth, um, to thio, allow them to hell and that form off closure of the wound if you will. The bandaging waas pressured. Okay, You know, initial mental locust escrito common tipo Devinda uncle know existed Oppose Clara Mental Venda Hekmat Alberta material. Pero seek electrode s a tip of the president's or Elastica trees princes Oromos strove hard. Uh, gamatoria une will the logical reasons you need petro FICA and it's a moment the, uh, platinum. Uh, listen, Booth, uh, those were the original in the 16th century. And then in the 18 hundreds, we first saw the boot, um, to to manage, uh, burn scar burn wounds. Now the owner boot we used today after surgery from the 1800 to 2000 and 18, we still use that they wanna food. Do you understand that? On what is my roberta? We're not boot. Yeah. I don't know what is going on. Uh, when I paste like, yes. Oh, okay. But you apply around burn wounds to help the healing process. Okay. Entrances. Otra is strategic here that the utilization eso the l Brenda Harvard Akane Jess O Mara para poder a syriza president. Sorry, Elastica Trees. And then in the 19 seventies, first time we see pressure governments like what we see today Okay, there's the millions into Potente JMP samosa Where a Incontrera evidence via the press auteur Apia Colic Chris Kaman told Maintain also throws Lazutina's Amos. So we to this day we don't know exactly how much pressure is required to depress hypertrophic scars. People have different opinions because we don't have the evidence yet to understand our pressure works on scars. Okay, Being on a spectrum important Yes, l a precision. Que tanto President Sarah Carey Obama's applique are in Miss Tipo delicate, you know you consent so specific, Okada in the single Orica persona that in a community there uh, concepto uh Okay, I algunos algunas gs all the Mementos Berna Pero which is someone gonna controversy? A que tanto president Podemos applicant Lee Committal Elastica trees Travis Dellape etcetera. So the accepted average pressure we use today is 24 to 28 millimeters mercury in terms of susceptible Moscow Kamala Harris Cammarelle fighters Promedio Burnham promedio Casillas a cow the consent of parliament nose. And it's those especialista says entry painting Quattro in tho. Millie Metro's are you know the mercurio. Uh huh. Is this Kamal Kamal A pretty understand that. Is this e a unica Puerto in is a 24 to 28 millimeters mercury pressure. It relates to the capillary pressure within our tissues are capillary pressure is 25 millimeters mercury approximate okay, don't say low groan effective jacquille oppression. Capital are in promedio Is the vein t seen commonly? Metro's Maranto says. Local CIA says camo Punta internally in trying to quash driving Coach Para Puerto effective. So we we think that something like the pressure government 24 to 28 pushing down and then the capital pressure pushes up. So we want something equal to keep the scars depressed. Tons of locals Camo says Celebration can also supply camo says X The direction external. I interna Vienna siendo interesting sequel driven tho l oppression. Internal party capillary asi afuera is the fantasy in Copa Loca Ramos or local Muslim contract is it means money. When the president some some off the studies that we did with Dr Herndon showed that as a little pressure is 15 millimeters mercury, it's okay to depress the hypertrophic scars. And Dr Pressure's off a 40 millimeters can be destructive to the scar to the wound. Okay, Doctor heard on, uh, case investigatory Professor but which is an assault? Rosa Studio Low Grade. Muestra Kikkan Kinsey, Millie Metro's Mercurio, Cyprus Lascuna in effect, O Farrell, Adults and Elastica Trees versus Killed Also they man the Corrente Millie Metro's podria Hanada um Daniel Maceration. So very Elastica trees. Now the latest research on pressure government shows us that after we apply garments for one month, the government will lose about 50% off the off this elasticity Los investigadores on logrado almost Rourke a party del primer messi also the Prenda Aleka can also to express cream Most investors worry about police are superior it and it's a primer misusing cuenta por ciento compression. So it's very important for therapies to check the the pressure on pressure governments often very often Hey, treatment for lo tanto is more important. Para Ella Keeper Rehabilitation Darley Sacramento Control muumuu cercano a supreme ERM, is that, uh, you know there is the sin cuenta por ciento. You know that you mean yes, Belarus. Very good. So there is some research that was done and you can find it in the journal Burns by Dr Lie out off China that shows. But pressure governments actually help increase the amount off Latino sites and my oh, fibroblast within the tissues. Okay, So, Dr Chino Doctor line. Yeah, Low gray Mastrogiacomo, Lapresse Terrapin Union impact or toilets Technicals Vardalos, Willie Crittendon Impacto positivo Jacquet. So the last tree Jackie bodies Minuit production The los que Latinos Ito's is lost me a fever of last us elective dakedo standing razon por la cual Sayonara, Elastica trees things. This is important research to justify using pressure governments. Because, as you can see here in one of her slides, it shows that before we started pressure government there was 60% Piper Plus and karate, no sides. One month after pressure garments, it decreased to about 30% and three months to about 10% as opposed to those who did not have pressure garden. Okay, for the government is pressure garment. Okay, come says Spinella Philomena uh, la Primera Colombiana over local comparisons. Okay, So sorry. Escaped were impressive present therapy. Okay. Just Cano and its imprimatur in primary group. Tenemos un sente por ciento toward a higher the money when you say it is probably fair Asciano crazy mentors or denial is correct, you know cities. Uh, even Mastrogiacomo, Progressive mental Messala stress messes, but that's a lotta Casey. This minutia is secrecy. Me interests Ordina in those spaces, tow us. Who still is the studio? Whose is the car? Grand party kratom in Tokyo. So trust every names. So inserts are what we put inside pressure governments. Where there is con cavities in concave areas, we put inserts in order to build up the pressure toe. Achieve 24 to 24 24 to 28 millimeters mercury pressure when Allison Certo Solitaire, Apia utilize Andrews in ciertos posed a permitted money. Hard, uneven Della superstitious conquerors uh, el mismo nivel depression instrument equal treatment church para poder where the Communist re with suppression Yeah, order classical Theresa's case an assassin in is a superstitious and these inserts can be, uh, jail sheets. It can be phoned. It can be party can be a last summer. It can be silicon. It's any material um, a circle owes in certain for most utilities are hell and Mohammed a INL Amina formal for me s Pumas las Olas tomorrow because Camano silicon Alberta Moldea Palacios, Kamala Plasticine plus Lena and Travolta's. So if you can take thes example of the hay of the head. You can see that here, if the head is round is uniformed pressure, you're gonna have maximum pressure on the nose because it sticks out. So there's more pressure. Um, that that is exerted onto the nose and less pressure on the sides. Understand? Okay. Estas insta grafica Most, uh, Cabeza Gorda. This is uniforms pressure. Uh huh. And then the most a trabajar una president Uniforms in total contour No in El Bei looking for the most observatories Maximum President Anibal de Neri's like that. And you on the, uh, Sona Lassana Maximo and Lana is minimal. And Lassana temporal intermedia are gonna party Post re, then here. If you look in between the nose in between the nose on the cheek area, you're not gonna have any pressure. So you need inserts there. Okay, in tons is in trail Honorees it co Motorola partida most delclaux gonna suhani ano podemos I noting element multiple oppression Cuando pensamos An illusory literacy in tow. Uh, same thing in the web spaces, right? You need inserting concave various in terms is in is a zonas animal. Then there is one evil Della Telesis passes in 30 Italy's years and on the poems utilize Allison Ciertos Parramatta your presence or Elastica trees so you can see here a small video. How putting foam inserts inside the glass can increase the pressure in the Web spaces and allow movement so you need soft inserts in moveable areas. Dances in stereo must be endo Local Okecie Angelo sensor toes and areas Conquerors Where the arias cousin Deflection Deaconess Seton Tenero Montenegrin A compression dentro del means more than training Matra complicity So one of the most common materials we use or inserts is silicon who know the laws materials case on Moscow movement to tell this house. Come in, sir, Toes on a local conocer Moscow Silicon silicon We don't understand exactly how it works but lately we understand mawr off how silicon works on scars. Okay, No tenemos claro Com OS Conventional silicon payrolls have a mass confusion. So the function of silicon on the scar is softening the scar, making it more elastic, making it flatter, helping with teaching and inflammation. Okay, I'll effect. Oh, okay. Said Houska Alou's well silicon So realistic. Atriss skc uh Logica trees Mass Elastica Espresso Mass planet Casey Hruska l Commission Lavicka's own El burrito e que said this Minutia. Coloration row highly inflammatory. Okay, now, as I mentioned a moment ago, we don't understand exactly how silicon works. But this is what we know. In this latest research, it's it's important to understand hydration off the scar. Okay, but tomorrow momento para una Portela loose. Oh, the silicon A to us over Elastica trees is equal is on that story. SKC An investigatory and low grade must raise effect. So hydrating this car silicon silicon on top of scar will help the scar become more moist. Okay, l Silicon Kalakaua. So very Elastica trees a Judah. Come on. A acela. Comas. Blenda Masuo a So I decided to heal. So? So if you bring moisture to the scar if you think about it Water, water carries oxygen. Right? Okay. You bring oxygen into the scar, you reverse the fight. Process off the scar. Cuando nos otra laurinda most either at Ascione Elastica trees. Lest, um, Redondo oxygen a largely or in the Roxy Henault locus Amos SK is a production or is active via capillary. This minutia. Yeah. This minuit influences as a must collect yellow fever of last question being saying Eva for lo tanto, I do the most. A case. Secretaries McComas Lana imma swat reflex you. One other important thing about silicon is that it helps increase the temperature in the tissues by about 1 to 2 C. This increase in temperature will help break down the collagen. Hello, Tro aspecto factor importante CMOs Latin Paratore Prusek five or a cell whose well, silicon in terms is knows how men town growl Marla Lebanon growl. Uh, temperature record for a lesson. And on the local yes sentences looking gradually ease. Uh, these men with bacteria animal, they'll disorder in bird A and collagen O E s t o Judah Controller Lasek Patricia. So I want to explain this. Maybe with this, uh, cartoon you see here, this is the research off masto. Um, it's about 10 years old now, but this is very, very important to understand how silicon works on the scar. So if we go ahead, Gina, Michael ba I slick Arno's lay investigation The Mostow acerca colossal effect. Oh, the silicon Zorrilla p l s or L A secretary. So on the top here, what we see is the top of the scheme. The stratum corny um I Areva Balala parthemos except up almost linear Aware observer ls trato Cornell. And there is no silicon here. I know I own with local silicon. So what happens to the injured skin? The hypertrophic scar you see there on the top of the scheme. It loses water. The the the water evaporates through the scar in tons is in is a cinemas external tenemos contender in mechanism. A lesion studies tratando sista perry in Doha. Wine is a sauna external, so the scar becomes dry. No oxygen because there's no water. In turn, says Logica Trees sister, racy condo Kelsey. It's a it's a risk and assist a party. Indo irritation Ebola canto Susie Ela picked in terms is contrary. So when the scar pick dry and down the college and becomes more disorganized because there's no oxygenation to the scar in tons is como esta? Also said in a less trato Cornell apartments. External, an evil internal cola. He knows, says Jordana. For cases or Dana Pork in or receive a look. See Hannah sufficient. Here we put Silicon on top of the scar. That's the silicon in terms is in Lasi in team ahem, memos in saffron hassle cola coddle silicon so we now prevent the water from evaporating in tons is a loose O l A cola cash in the silicon privy any Lapeyre, Dida, the Agua Bardelas irritation The Arizona the lapel. So the silicon now includes the scar and preventive operation of water. So the college, and now as oxygen and becomes more organized and breaks down easier in tons is calm. Areva. Tenemos l silicon Kennesaw Mountain gorilla Allegra Osceola Tempera Tura Poison tons is have a hopeful apartments Interna El Cola, you know esta oxygen out. No, Einstein tons is crescendo All this Arredondo said Vera is a manera this Ordina. So that's why we believe that silicon produces hydration or collusion. Oxygen increase in temperature increase and pressure. Government is the optimal Scott outcome when it comes to silicon and pressure government in terms of portal interior Mosqueda Lewis Well, silicon as usual. Um ahora Murdoch completely rocked asean animal DPL assume efecto placebo Use that I mean a control area Money hard Iniesta's areas they look cno Latin Paratore e ula common mechanism. The compression yes, stop was a sick optimal. But the in vehicle, uh, comparable elusive civic um, para el manage Elastica trees. So we did some research on We looked at Silicon line masks versus, uh, non silicon line mask. So if you if you look at them, be here, this is a mask that is line without silicon. This is a transparent facemask without silicon and transparent face mask with silicon. Okay. And let me Okay. Um ahem. Beppo Most absurd bar una persona que tiene una mascara. Kara can no t any silicon, Ella Ella bay LF Formoso Barguna Persona que tiene e una mascara Takara Berna con Silicon Anonymous in tons is Burma's com o la Um Come on, sit down. Cambio an evil There's a President Kabila, you sail observant eye in Lima. A member versus life is majority Lovell, Maine or in life. So we are observing less blood flow with silicon versus no silicon. Mhm. So this upset, famous essay aspect of comparative So So here is another example what we're finding out this is the same person, one person in all six pictures. Okay, Esta is the sutra employer. Luso, la mascara, silicon ella misma persona in stays, photos and saves momentos differences. So when we look at Doppler laser Doppler images off the silicon mask versus the non silicon mask. We're finding out that blood flow blood flow with silicon mask remains decrease for a long time versus the person wearing a mask without silicon that the blood flow comes back within 10 minutes about 5 to 10 minutes. Okay, in tons is put. Most absorb are in part a superior LA persona que tiene la You know l a mascara. Varda Petra is due in the studio. The Doppler Lius Telemedicine An evil they vascular. Okay, Pilar, even most Cuomo inla primeras sequence in l a party Superior s a mascara Connexus Silicon Monty in El Oppression incluso the political cell Akita Vera accelerated in Montini's effective current for my elementary in a current is in communities this quest versus at kay the person the hard element persona con mascara seen Silicon cannot keep Pasadena majority party. Uh, you know, Capella cannot. Even it doesn't affect the compression economics castle remote areas like it'll a mascara, a pain until effect of some anti Peronist seen communities. So that way don't know what this means yet, but maybe one day we don't have to wear pressure. Governments 24 hour days, 24 hours a day or face mask 24 hours a day because off silicon again maintaining low blood a flow France's president uh, total les llama comma La Razon The poor cases defacto calcium party and no Latina Maspero and lose the studio s as in Sam Estrada, a loose o l Beneficial Utilize our l Silicon comments herto silicon in mascaras or entro La Liga last perilous Get out! So pressure and pressure governments and inserts working together now help two degrees blood flow. Okay, Ella Perrilloux. So the loss in Cerritos past and effective but not so realistic Waitresses help Ramirez cases. Manoj it's a fluid. Oh, this angry. So lt hell, help decrease oedema this Manoj Let them. Then pressure and silicon working together help reorganize the collagen with issues Like we said before. Lapresse Schindel silicon A Judah Issa's Banda's ecology knows Wandera organizer the manera parallel. They help decrease teaching and scar pain. This minutia Judah at this minuit low case l pajarito comments on a Picasso e l dollar and again pressuring inserts together help discard maturation, process accelerate even when a person, a doula, a solider will process So the madrasa and Elastica trees. So here is some research that was done by Ingrid Perry in 2012. Um, that shows, um that silicon, right? Very, very important. Um, when we apply it onto the scars early on, it will help increase the amount off surgeries the person is gonna have later on. Okay? And a little milk does in Greek. Darius. A studio and equal s to compare a definite Amalia spiral money. How the, uh, see catherization in Westra Com o burda CDA una The most regulation onerous Mnuchin. And it's a process of psychiatric Al Khani Lusa l. A silicon. So basically what she said what she found out in this perspective, random my study is that pressure You can see here how significant it is. And then Silicon Silicon Most important and pressure. So pressure and silicon working together produced decrease numbers in Vancouver. Scott Scales e sorry for eso Pressure CC senior. Yes, Okay. And Nelson Misma Studio, located in Western sk l oppression Burda. But at the near post soon efecto on being Marilee Ikle oppression or loose oella. Presto therapy. Pero I'm Asuman Dolisie, Ricana, Silicon Perdon by as you are at in a room. A whore. Efecto Salmoni. Hola, Psychiatrist. So you can see massage pressure, Silicon silicon. Most important, right then pressure and then massage. Okay, so you can see that these modalities now that we do to manage the scars, pressure silicon massage are important in scar management. Sometimes I use this observant K l. Mazza has important heresies. You can be in la Parisienne, pero with inla Merida Same friend Silicon Vera Judah, the party in my significant CIA out at home to assail effect Now remember talkto life from China before we mentioned that she showed us how pressure garment affect my glass. She also looked at pressure apartments and how they work in determining the thickness of the scar and how pressure governments alone pressure governments with silicon and silicon alone How it affects the scar. Okay, Dr. Leah, the studio Chino the Personals Barack a The mystical Orissa circa delusional silicon. Uh, when l a grand the minstrel compensates message that Rahami in tow. Who? Sando and um Grupo seen silicon otra group of con silicon vera a une effect. Oh, the cameo in little gross or morale tour. A committal, Della Uh psychiatrist. Yes, that was mhm. So she showed us that if you don't wear pressure garments, the height off the scar would pretty much remain the same. Yeah. Yes. So in tones is but, uh uh, minority important. Most horrific toe Prada. Paciente, Elastica trees. Uh, look, Selenia continue like a Michael. Yes, that s a group. Okay, No. So ninguna material comp ratio when they drafted the same message gross or the last egotism. And to the the other groups the pressure government group, the Silicon Group and the combination silicon and pressure it very well in six months. Mm hmm. Yeah, we're more sentences, Vera. El Grupo. Completely. So silicon. Hell group. Okay, combine Allah. Those therapies, Keira Presto Therapy a master silicon questo were much on my heart, which I'm a whole revolution. So that's another evidence that pressure governments and silicon work on affecting the scar history Sentences of provincial com o l silicon L. A presto therapy contribute General Manager Elastica trees. So another very important thing to know about scar management is stretching. Stretching off the scar stretching off contractors. Mhm. So the term slow, gentle, sustain stretch. Okay, it zero the scar. Susan m Lusa, Della uh, because it's just so for now. You. So the last federal isco modelo is a position aumento assay. Unistar, aumento paseo. So lot sick Trees Yes s terra me in tow and dances knows a Julia. Okay, Aja, calm things. Munition and crecimiento elastica trees. So when we stretched when we stretch the scar, we have to do it slowly. Not very aggressively. Okay. Cuando estamos en este tipo The memento the most him till is the most, uh, Passo Passo Progressive. Oh, no. Aggressive. Oh, Vera or maximum does the help in the moment. So pressure, I mean yes, and federal loans are important in lengthening stretching the scar. And who saw the Jessa in Dallas? Fabulous. But it's not bad country with a U. S. A. Still I mean, if we become very aggressive in the stretching, we can cause micro trauma in the scar in the in the tissues cease almost ag receivers in str aumento mosasaur micro traumas lesions important is, in essence, the hero and the villain in the pl item ideological response. Super's. So that's very important to do it slowly and gently. His presidential says, Uh oh, this is for is so important. The manera progressive, Uh, Varios para No, honey, that isn't so. This is another very complicated study that was done to show the effectiveness of splitting and show us how confident we are if we use planes to manage. Contracture is the sooner studio. Okay, this is Michael is no spawning camo and analysis this yes or no controversial whose are beneficial, so knows our last fabulous. So in summary, I know this is very complicated, and we don't have a lot of time, but in summary, this light tells us that the longer we wear the spleens, the better we are in reversing contraction. No, my party B. We imagine this. Okay, that is a complete, uh, Romanesque interim Aston. Uh, but you see a contractor, uh, in prolonged constant, uh, a contractor. This is an example here to show you what I'm talking about. Instead, sooner he employed the local, Correa said, knows their account and a sutras. 1973. This patient was involved in the Vietnam War. Yes, the paciente and millions into certainty dresses toe in LA Ravine on, and he had this massive burn to the neck and he had the best surgery, the best nursing and the best therapy that we had at that time. In quel momento present ona k Madura, severa quaeda and participate in the trunk. O'Toole of my chorizo. Torres lost my heresy to handle that. My whole reason for Merah sell my horse. Centro para Mon Harlow. This patient here is from 2000 to is from the Iraq war, the war in Iraq and Afghanistan. Okay, it's the paciente when Okamoto estimates China and and And you know those dildos in la curandera toe? Uh, Madura in la misma Sana. Oh, yeah, he had the best surgery. The best therapy, the best nursing. Also. T o Look, my understanding Cerojano Serapio tas information is But look at the scar off these two people How horrible it is and think about what it thies to people not get Okay endorses Soto's absorb ammo sisters Those photography is where, uh for the most Observe our Ober kitten, the for mantises in capacitance this point, there is a secret tresses where vaporize the persona you know, spreading Thomas and dances Keano's fault. Oh, okay. Fall to Isis people For a Sir Fatah, every terrorist This is shows that the importance off splitting off fabulous. Neither one of these two Children received any spleens in turns. Esta esta comparison soon um us Trevi One important solu So the last fabulous Jack Esto ninos Johannes no less not receive no to unionism money. So other other modalities that exist in managing the scar include ultrasound I to therapy electrical stimulation, neuromuscular stimulation, but packs otras Malia's strategies Parral money Hold the lot Psychiatry's Villaseca tresses Uh, princess Loose Electra Sonido larosiere Apia law Stencil A stimulus in electrica madani Well nervosa less stimulus eon electrical neuromuscular He lost pocket says Colin we we don't use a lot of these modalities uh, in Bern rehabilitation because we don't have a lot of evidence yet some people do, but we don't have a lot of research. Tell us we have to use them because you chose the sutras or in general, no socialism. Tanto estas Mongolia is Jackie fault? Ana Roca Mama's investigation is okay, algunas and process so no salvatori um as evidence e a para loser is also paraffin wax and fluid therapy. We need we use paraffin wax we use hit to warm the scar. The scar before we stretch the manipulated. But we need more research. It was meant to pass a gonna lose Oula para fina economy afloat European because I am a scallop Aravena bar uncle or in a specific until arena facility logo told us instrumental. A marvelous ASIO on Yemeni, Hopeless as a fault. Investigational respect Another modality. Uh, that is very important. And I know maybe you have maybe 5 to 10 more minutes, but it's massage otra estrategia moving. More important para nuestros is l Masai massage eyes utilized by a lot of therapists in the United States. I'm not sure about how many of you use massage in Central and South America, but in the United States, a lot of therapists uh, initially when we did the first study, we showed 96% of therapies using and later 81%. So a lot of people use massage most reporters in 1000 years utilization in Masada in many ways. In 19 AM I call Colorado. This is your own investigation. Most Stratan demonstrate Okay, Castle nine and restore terrible loss. And is movie the way I am clearly spectra the Russo, the massage. So we don't know a lot about massage. We need more good studies to justify why we use massage in burned rehabilitation. A simple Thomas investigation. Honest, but the most Robert Dill L l effect. ERM Asahi. In last secretary says, Yeah, in 2002, we showed with Dr Herndon some techniques off massage, But then in repairing in 2016 as an instructional video on massage that you can a lax is on. I will give you the website right now so you can get it for free. Um, but these air good techniques, uh, that you can practice, Uh, when you're treating your burn patients, you have to be aware off the different stages off massage, Okay. And l those mill does is Sierra. On my colleague Dr Heard, a noona investigates youngest burn in a literal total total worker acerca de la's technical Masada Cinco tipos the technical If paralegal millions is a single party lacrosse or a English pari assay an evil these 1000 years is Central America in a studio and a participant different Extra Perrotta's Burda Elegant Tenere Yes, and that is our DST pose the technicals. The Messiah esta technical massage is Stan and video case that delivery access of Carino so true, you cannot invite Americal Consul Avello upon practical chronic stress positions. So So it's very important to be careful when you do massage and you start with non friction, non frictional massage and new progress to frictional massage. It is important that Qantas muscle massage No, Henry are gonna friction. But the initial uh Paata no listen, a little hell when the scar is very fresh is very painful. You have to be very gentle when you do massage Cuando tenemos una zika trees Case in Madura esta Colorado Hokey stardom We resented Barcelona Zona Moore Dolorosa Imo isn't serial Tokyo Rose Paula tanto most in a coma? Jorquera Allison, Ariel Masada And it's those criminal moments. So it's very important to progressively do massage according to the scar maturation process. Ellman's ahead in a mosque a law evolution Andrea Tando al Nivel In case Thomas Rosica Trees and evil democracy you know So first, when the Scott is very red, be gentle And when the Scott is becoming more mature Mawr Mawr uh white more pale You can be more aggressive Quantum coziness Rosica tresses Stand the color purple Rojo the most mature Montilla square. Also, uh, respect. That is a factor. Dado Laura or the, uh, movie person civilian Cuando elastica trees ba in Saturnalia Ma Rosa inclusive Blanca Formosa McComas Aggressive, uh, call a technical gets. So you can all access this video our online by going to this link to this website and you can get it for free. You don't have to be a member of the American Bar Association. Ato access it. It's a very good video in English and Spanish. Um, no assistant color conduct esta link s l L Bean Link the access So lost videos SRE mazar Stanton Tony spaniel. Common English is Stan Cohen Access Party Ratra Isela Association Americana, the Madura e Pepe tomatoes and access. So they consult tatters and I will be glad to. If you don't have time to write this down right now, we'll share it with the Bianna. So whoever needs it, we can get it to U s. So you can access and view these videos. These videos are free and you can take them and give them to your patients and teach them in your clinic. Michael barley is the access. So it's the link, Viviana, but I'll give you an apple local com particle count. Dinosaurs. I'm gonna I'm gonna close this lecture with some pictures on Well, discusses. We go here, these air pressure governments and today pressure governments can be aligned with silicon eso we can have pressure and silicon working together is doctor lie showed Bama strata title gooners photography acerca de Malia's They also the press cetera p a l s like Chris Kahn Silicon Ah, particular studio, Dr Line. They're splitting materials also that align with silicon so we can stretch the scar with splitting. I mean, promise with her materialist thermoplastic calls parallel or a C on the fabulous fabulous Kino sagen is, uh, you know, silicon is a compression. You can make mouths Prinz to stretch the commissioners of the mouth online. Those planes with silicon is the Tip O Farrell is a walker con silicon. A material thermoplastic opens nostalgia serving, um, a whore compression compression behind the ear that can be lined with silicon. Also very simple spleens to stretch the scar con el luso Este tipo material come in poems estara mentos in Moldova, specific owes, or elastica trees, axillary compression, silicon and pressure in the auxiliary will help you increase range of motion. Mm. Promotion era Nivola. Csilla tambien compression para incremental ranga momento put Ahem. Princeton photography. Uh, any well, the Ambrose, you can see, uh, compression mosques. And we have done a lot of those, um, in central and Latin America with the therapist. They're transparent face mask. You can see how they can affect the scar. Uh, stay. Carson is the photography is best Hamas window camo. A localization. Jonah Mascara in material. Silicone Alkon. Uh, critical con silicon. Uh, whose telecom precio? Niels Ajemian top loga is the effect of final animal the car. So again here this slide again. I just mentioned it, but compression with silicon can increase range of motion. Very, very important And reverse contracture. Um Akiba Moscow mo progressive aumento low Grandeau. You gonna maha Reflection The Ambro Marda Yellow documented you, Alain esta ultra photography again with web spaces we mentioned insert in web areas in concave areas can help increase the web span the range of motion. And it's the castle Vardalos. So the lifespan, how the loss insert does the spoon how this is called silicon and it's the areas conquerors presents a Julia Momenta. Los primeros passes so you can see all all parts of the body. You can apply pressure and inserts and you can help increase the movement and flatten the scars in culture. Part el Popo Moses Compression application The certo si con esto pose my Horia para majordomo Julia. Uh, no Chris CA Della psychiatrist Amanda Cortina. It's very important to start this mortality is very, very early in rehabilitation. Don't wait, uh, to start pressure, government and silicon And another modalities. Uh, it's very, very important to be aggressive in rehabilitation and rehabilitation. He put my convention, Akiba said, more important in easier de manera moutain prana last like compression Burda a loose ol silicone or the ultras Estrategia para por compliment Elastica trees. You can you can intervene early as soon as the wounds are closed with silicone and pressure garments and you can have good results. Input the inter veneer temperament. Uno s Lassana is the pls Fonterra's postpone almost lograr Burda woman horrific toe in s a factor The crecimiento l a psychiatrist. So in summary, I know scar management can be very complicated. In conclusion is, uh Wesselman. Hola, Zika trees is one area the official, Barda Barda. But I think we all agree that pressure pressure governments, silicon splitting are very, very important components off managing the scar. Pero total system most acquired a in Kayla precision Lasi. Elusive silicon Liuzzo Federalization eso lo suspect Those most important espada minimize our loss effect owes the last Secretary's Ascione hypertrophic. It's very, very important to start early in scar management. Don't wait until you get contractors and hypertrophic scars to intervene. No, there must be no there. Most esperar a que john contract. You're a skeleton. The formula It's in the Muslim pesar temperamental e pre veneer is a deeper complete concerning and finally is very, very important to do. More studies, more research. That is, uh, quality research. All these fields discussed today. Um, if finalmente pencil nothing Vita tosa por el Our studios investigation escape on demonstrate que loca semos Kamala Seamus An extra special interest in, in effect, two years support pajamas. But crazy me internal area, our hellos percent disoriented, came out. If we have time, baby, I'll be glad to answer some questions with Gina. Otherwise, thank you all very much. I know this is a very complicated topic. Uh, but please contact us. Uh, Gina myself, there is other therapists there in and through America that can help each other. Asked a question, Michael, mention a k sittinon alguna Pregunta Kornienko, Gusteau e que tambien and called momento el correo electronico. And contact our nose. And Michael O'Neill, Casa mia mentioned Tambien or our true escalada Central American Escape Plan Burda Iquitos for a massage. You got, uh, actress area from there. In the study, we have toe, we have to work together. All of us thes group and many other therapies toe answer a lot of these questions and help each other. And that's the purpose of these meetings that physicians for peace are organizing for us. Que el grande patio de stas secessionists escape people. Um, also need no score more group of the terracotta medicals and firm eras rehabilitation a para po. They respond there. Pregunta. Suppose Arno's intercom. Your experience hasn't beneficial industries. Pacientes Yes, we have time for questions. Michael, Thank you so much for helping us. Actually, they started toe right down some questions. So the question is from Liliana Arango and she's asking Hello afternoon. She would like to ask what other strategies beyond the governments are used for those scars that are hyper sensible on bond Because the patient doesn't tolerate that type of pressure and contact Andi. Therefore, she cannot use the present therapy we can use. Can you hear me? Okay. Did I lose you? Yeah. I'm sorry. I am gonna read the question in Spanish as well. Everyone knows. So Lillian Arango's apriyantono LaWanda started. He said a printer. Kyoto strategies for elastic students. Utilization paralysis, tresses, Sistani, person, syphilis, masculine says young person to know too little contact people in the precipitous press. Okura. So, uh, to answer this question, that's a very good question, Liliana and, uh, we can use bandages, elastic bandages. We can use carbon eso we can eliminate the friction. I'm trying to find some pictures, but I think bandages eyes very, very, very effective. Any kind of elastic bandage. Some Lycra governments, uh, I mentioned before. Low pressure can be okay if we don't have the custom pressure. Initially, I will start with something that is very, very soft, like less pressure and work towards high pressure. Okay. My conventional Que podemos utilize our La Banda Elastica But that's just giving in common. Royo, uh, in the Seattle money. Who convinced Paciente? Remember, most of these are Cohen, uh, most utilities early. Crass, uh, con una Minner precision. The tal manera que los pacientes vagina costume Brando progress here. Mantilla Posterior mentis IPO. Almost call a car la Presa Therapy Akane majeure Compression Zorrilla zone. Any pressure you can use is better than no pressure. Okay? Who says foreign lotteries are calculated Ploy material, Kenny represent? No Soto saying in Costa Rica, Theresa, most, uh, Cohen, you Theresa Muslim venison Banda's Elastica Utilize a most, uh, algo Priscilla's cochinita Eskom elastic, uh, cochinita pharmaceutically sorta being licorice in Punta. And I'll go on no necessary meant jolly crus, but, uh oh, Sabra. Thank you. Uh, there is another question from Georgina de Eggs, or I hope I got it right. So she said, I want to say hello to Michael in 2014. I have the pleasure, uh, to do a rotation in Galveston on I'd like to know how to do, um mouth splint in burns like unilateral burns. Just one side off the face that that includes the the mouth. Yeah. Yeah, those Hello Georgina. Those are very complicated spleens to dio to manage the unilateral contracture. And it you have to have something study into the mouth in order to unilaterally stretch. Uh, I don't know if that makes any sense, but I'm gonna try to find a picture for you, but it's very difficult to do the unilateral one unless anybody else has any any, um ah. Examples. Okay. Okay. My culture Saluda Georgina, This was car una photography interes para por lame camo induced comas. Ultima e l mention a case. The official Cuando Savannah's fellas, the walker is on the wound solo lower four oclock Vera portal opposes the only para el sustained committal. Doesn't look at serious boost para el gouna photography Elsie Argentina in El Gouna, uh, or try their with photography Acomplia com potato. They realized that was condo para responded Georgina, Um I'm trying to see if I hear this one right here. Can you see this picture? No, no, you are not sharing your screen. You have to find now, uh, you have to share it again. Like I know I lost. You were unfortunately. Hold on. Here we go on. I'm not sure if you can see that now. Yes, so that zone example of a unilateral Commie sure spleen, But it's very, very complicated to Dio. This involves a study piece that goes into the palate off the mouth instead. Soon ejemplo the tipple. Ferriola Kapadia Most utilities are Cuando i lesbianism Solo la la boca. Okay, personal look. It's mood efficient where that tanto levar our models are if it's a unilateral contracture is more complicated on a bilateral contraction. But you can try any of these techniques and see if you can achieve any stretch. You can also, uh, stretch with a hook, and I touch it somehow around the ear. If you can picture that, they make one hook on and put the last thing around the ear and see if you can stretch on one side. Only my convention. K funnel Money Hoc Andres The one Solo laugh National deficit Perot Connecticut soil tambien Harry Perera said when people Ferriola Cuba Dentro de la Boca Sally Common People, Rancho Lazo Easy on Syria, Al Guerrero or unplanned Allah. Allah, Allah, the Talman Iraqi sala Maintain is a lot with, uh, lascivious Yongkang uh, elastico couches. Marla Entry Lazaro Noel otra para los artemisinin. Poquito comas flexing morbidly Okay with the committal Central Okanagan show that is, that tracks Yankees in Mississippi. Thank you. I hope that helps. Yeah. Okay, so Julia, respond the labyrinth. Um, Charito from Peru. She is saying good evening when I have a niece car with a small residual ulcers. If I can start the place of therapy Yes, yes. Hello, Burrito. Uh, just a proton sitio trees Competing also raises Wallace Mystery Lucilla Episode Arabia. Yes, you can. You can start pressure therapy even if you have small, open areas. Just make sure that was small. Open areas are dressed with a small dressing and you can work with pressure and talk. My comments. Yannakis. Cilla Saunas. Elysian Son Pequenas Cheritto podria Gallacher album tipo the posit Oh, Vera is always deposit Tokelo car lot compression. See some potential Asan. Myra, eat Amanda Saluda Charity. Yeah, Okay. Clara pass from Colombia. She's asking good afternoon how long the silicon is usable or is works on. How often do you recommend that it needs to be changed, but in e no, I mean, it's my right with a Tardis Claritas front and the quantity polysilicon contest Recommend that you can be so the silicon can be used for a long time. It doesn't expire. There are many kinds of silicon you can use. You have to make sure that you wash it. You watch the silicon every day and you wash the skin. You don't want to leave the silicon on the skin for a long time without washing it without watching the silicon and the skin. But silicon does not expire. This buyer, it will last you for a long time. Uh, OK, yeah. L Silicon Montana Tina Fey Respiration. Pero see? Look at the recommended a Kona Well, how on parquet with regional star in contact will appeal Uh, co haber that again is gratitude. Or so the sections And even yet and does this post para guarantees are key Nonagenarian ninguna reaction Ideal area. Uh, seven hour? No, para not really experience, you know, Termina. So one thing we have to make sure is that when you use silicon for the first time, you put it on for maybe 2 to 3 hours. Okay? Make sure the person is okay and there's no problems with the skin in the Spanish theory. Loser silicon. Okay, so here s K whose Poco Carlo Calvez Peruanas does Horace Vernet Nefario CIA Your generation alguna larry gonna molest uh, Connell paciente una persona is in Opus Puerto Santa Maria Perez Cancer. Recall a car, Lorena. Yeah. Then if there's no problem when you go to six hours, then 12 hours and then you can leave it on 24 hours. But make sure you wash it at least once a day. Um, Houston sentences dispossessed. So those orders for incremental a Quadra Cesar does a venti Quattro ra's Pero si de lavar committal l silicon para guarantees Arnold Verdell efecto Olympio the this cretin a Charla So real appeal is or Elastica trees. Okay, two more questions for the first one is from Jessica Cruz. She is asking, Good afternoon. I have a question regarding the scar management process on. I understood that you have to do it once they wound is closed. But in terms off timeline um, Ato What moment? Approximately. You start that process in Spanish. See, Jessica chooses the Rotondo. When I started the monkey to frontal in Israel processes catherization sex as a parent tiempos proximamente in a moment. Um, that's a very good question, Jessica and people do it differently. What I would recommend is that once the wounds are closed, you wait about maybe about 7 to 10 days after the wounds are closed and you can start doing some non frictional massage, and then you become more aggressive as time goes by. But you have to be very, very gentle at the beginning not to apply too much force on the scar because you're gonna have problems with blisters and boy as or a wound breakdown. Um, one of my call in the Cocula pregnant that the company is more important. Kjos s a hearing. Murdoch recommending Corona is lapel esta Saraya Florida's da Serra completamente is para entries et a ds ds part I Monsieur l myself Hey, pero que certainty! No, General Electric CEO no era, huh? Moocher Rosa for casino podemos A serum pooja solution is appear quite common that pero pero el tiempo ca is the a S D s post area resize the syrup So it's very important to look at the scar And if it's very, very red, very painful, both slow go easy. If it's more mature, be more aggressive. It's important tickets used to observe Elastica trees. Roa Ido LaRossa applique illustrator. He has pero de manera tha you know, aggressive Bella para thistle agenda Present Cement is a color is coloration. Yes. So Laura is a person civilian. Larry, the scar is very hypersensitive and very painful at the beginning and very itchy. So maybe after the wounds closed or almost closed um, you can start with having them touch. There's different textures, then start putting pressure. Then start doing massage to start slowly and gently. Mm. The most recorded classic tresses. Initial men test on Rojas Muumuu, Delarosa, CNN and much of Credito. Until this Lysistrata he's Catholic. Most presidents hen Tillis data and said according Saleh Tolerance help ASEAN eight Progressive element applicant dollop ratio l Mazza Health called ill as the master strategy. Because if you see the video that we talked about, you will get a good idea on how to progress on massage. For example, cuz s uh, Puente del access will be the okay. No summons, You know, start Antone English Communist Manual. When I observe Bad Como's isa Professor Morrison, Elastica, Trees camo Redondo El Award I E requirement. Thank you. We have one more question from Jesse Niya Ako on, She says. I know that there are few studies or research about the use of the kidneys, your kidneys, your tape, um, over those scars on Guess research about the tension and the pressure using that Tennessee tape. Onda she's asking if you have any reference or any information about this, Actually. Hello, Yesenia from Panama? No, Uh, I am not aware of any good studies on kidney show taping on burn scars. I don't think we have good studies. We have good clinical observations. People started using Mawr and Mawr initiate tape on scars but there is no published studies yet that I'm aware off from burn therapy. So if I find some, I will send them to you. But I don't have any information right now. It is good. You have to be very careful how to use it on the clinical observations are good. Michael Saluda, Yesenia. The Panama is gia in in Saudi la Pregunta. My comments Yona no tiene en este momento uh, nacion over that articulos pork was no tantas investigation is al respecto Look, listen here Just any Ayat assis Pereira sell observation clinical come over l evolution. L'm anejo Belkin issue take broken este momento. No, Canosa, They are Piccolo's. Where? That the message. Ascione Kasem Publicas I'll respect. Okay, now is Tenga Solossa. You gotta just sending come you choose. But more and more therapists in the United States used kidney CEO taping techniques to manage burn scars. So hopefully we have something published very soon. Can is the moment oil Chicanos Manchester about a skin and lost thousands Standard Elizondo Elkin is your tape barrel money hold The last secret trees is okay, Let's spare, uh, pronto mental Jinja publicas units and respect you came for. I have one last question, and after that we can just end conference. Uh, it is from Liliana Angle from Colombia on dshea said another question, Uh, those, um, garments, compressive garments that you are suggesting? Uh, those have one, like, unilateral direction for allegation. Or it can be, um, bi directional, like both ways. Yeah, I want Okay. Like Sabrina Complicity case here in my call The United Action. The long asean. Okay, So I will be the director. The the pressure governments today are stretching both directions. That's the answer Gala. Respect for them. It's a Preguntas skin is the momento Lycra l A press. So therapy A There is a directional. But at the near Bernanke movement Hora who stay he control so real a psychiatrist. SLRs was the same thing. E think that's what Liliana is asking? I think so. Yeah. Michael, thank you so much for your time. Thank you so much. Once again for sharing your knowledge, Um, for being here with us and for Want us to know more about Scott management? Thank you, Gene as well for helping us this afternoon. Um grab Michael Grace, Agena Forest. Aristotle, Akona Soto Comparative Sukanya siento experience Akona Soto's espero que yakuza much presentation case. Uh, they grow potatoes requiring que estamos bien, though often Alec a mess. Um, e s but most polos nosing continuum Inter finale. I also proximal mess Corno grande Like while interest Santa's Okay, Glasses toils. Thank you so much. Thank you. Thank you to physicians for Peace for allowing us to do these sessions. Uh, Ana Bianna for all the good work you have done, I want to say thank you to my colleague Gina Para from Costa Rica for helping me today and for sharing the knowledge on please. I ask all of you to connect with each other, communicate by email with each other, ask questions and we can find answers. You know, remember, we're sharing the knowledge and we learn from each other. Michaela is a cow, you know you stays for a steady participar de estos capacity Asians, Americans for the past I mean for Nuestro Punta and Centro yellow sindicatos a Paterno's communiqu Our intercom bear Karos Venza Hazara Technology Comment is much mas facil a Sarkar nose to nose out throws the Tal manera Kayla Communion Travoltas The professional America's infirmaries does for a muestra hard and Cohan toe and beneficial the monstrous pacientes lamonica manera But they put their there are no maharaja says intercom. VR experiences offender The otras decomp activity from the logica Minnesota uh, active via very good. Thank you. A Michael notice by a notice by