Effectiveness of various methods of manual scar therapy

Agnieszka Lubczyńska, Agnieszka Garncarczyk, Dominika Wcisło-Dziadecka, Agnieszka Lubczyńska, Agnieszka Garncarczyk, Dominika Wcisło-Dziadecka

Abstract

Background: The skin is a protective barrier of the body against external factors, and its damage leads to a loss of integrity. Normal wound healing results in a correct, flat, bright, and flexible scar. Initial skin damage and patient specific factors in wound healing contribute that many of these scars may progress into widespread or pathologic hypertrophic and keloid scars. The changes in cosmetic appearance, continuing pain, and loss of movement due to contracture or adhesion and persistent pruritis can significantly affect an individual's quality of life and psychological recovery post injury. Many different treatment methods can reduce the trauma and surgical scars. Manual scar treatment includes various techniques of therapy. The most effectiveness is a combined therapy, which has a multidirectional impact. Clinical observations show an effectiveness of manual scar therapy.

Material and methods: The aim of this work was to evaluate effectiveness of the scar manual therapy combined with complementary methods on the postoperative scars. Treatment protocol included two therapies during 30 min per week for 8 weeks. Therapy included manual scar manipulation, massage, cupping, dry needling, and taping.

Results: Treatment had a significant positive effect to influence pain, pigmentation, pliability, pruritus, surface area, and scar stiffness. Improvement of skin parameters (scar elasticity, thickness, regularity, color) was also noticed.

Conclusion: To investigate the most effective manual therapy strategy, further studies are needed, evaluating comparisons of different individual and combined scar therapy modalities.

Keywords: cesarean section; dry needling; manual therapy; scar taping; scars.

Conflict of interest statement

The authors declare no conflict of interest.

© 2022 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
The Patient and Observer Scar Assessment Scale
FIGURE 2
FIGURE 2
Scar dry needling
FIGURE 3
FIGURE 3
“Star” technique of scar taping
FIGURE 4
FIGURE 4
“Zig‐zag” technique of scar taping
FIGURE 5
FIGURE 5
Photographs of scar after elbow operation before (A) and after (B) manual scar therapy
FIGURE 6
FIGURE 6
Photographs of scar after cesarean section (CS) before (A) and after (B) manual scar therapy
FIGURE 7
FIGURE 7
Dermatoscopic view of scar after elbow operation before (A) and after (B) manual scar therapy
FIGURE 8
FIGURE 8
Dermatoscopic view of scar after cesarean section (CS) before (A) and after (B) manual scar therapy
FIGURE 9
FIGURE 9
High‐frequency ultrasounds (HFUS) of the skin with scar longitudinal section (A and B) and transverse section (C and D) before (A and C) and after (B and D) manual scar therapy
FIGURE 10
FIGURE 10
The results of the measurements the scar height (A) and structure (B) before and after manual therapy; average, average ± SD, and average ± 1.96*SD
FIGURE 11
FIGURE 11
Hydration level of the scar before and after 8 weeks therapy; average, average ± SD, and average ± 1.96*SD
FIGURE 12
FIGURE 12
Transepidermal water loss (TEWL) level of scar before and after 8 weeks therapy; average, average ± SD, and average ± 1.96*SD
FIGURE 13
FIGURE 13
Stretchability level of scar before and after 8 weeks therapy; average, average ± SD, and average ± 1.96*SD
FIGURE 14
FIGURE 14
Melanin and erythema level of scar before and after 8 weeks therapy; average, average ± SD, and average ± 1.96*SD
FIGURE 15
FIGURE 15
Subjective assessment of scar pain, pruritus, color level before and after therapy; average, average ± SD, and average ± 1.96*SD
FIGURE 16
FIGURE 16
Subjective assessment of scar stiffness, regularity, elasticity, and vascularization level before and after therapy; average, average ± SD, and average ± 1.96*SD

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