Physical Management of Scar Tissue: A Systematic Review and Meta-Analysis

Carlina Deflorin, Erich Hohenauer, Rahel Stoop, Ulrike van Daele, Ron Clijsen, Jan Taeymans, Carlina Deflorin, Erich Hohenauer, Rahel Stoop, Ulrike van Daele, Ron Clijsen, Jan Taeymans

Abstract

Objective: The aim of this systematic review with meta-analysis was to describe the status on the effects of physical scar treatments on pain, pigmentation, pliability, pruritus, scar thickening, and surface area. Design: Systematic review and meta-analysis. Subjects: Adults with any kind of scar tissue. Interventions: Physical scar management versus control or no scar management. Outcome measures: Pain, pigmentation, pliability, pruritus, surface area, scar thickness. Results: The overall results revealed that physical scar management is beneficial compared with the control treatment regarding the management of pain (p = 0.012), pruritus (p < 0.001), pigmentation (p = 0.010), pliability (p < 0.001), surface area (p < 0.001), and thickness (p = 0.022) of scar tissue in adults. The observed risk of bias was high for blinding of participants and personnel (47%) and low for other bias (100%). Conclusions: Physical scar management demonstrates moderate-to-strong effects on improvement of scar issues as related to signs and symptoms. These results show the importance of specific physical management of scar tissue.

Keywords: cicatrix; conservative treatment; meta-analysis; physical therapy modalities; skin.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIG. 1.
FIG. 1.
PRISMA flow chart describing the selection process.
FIG. 2.
FIG. 2.
Risk of bias graph for each included study.
FIG. 3.
FIG. 3.
Risk of bias summary for all included studies.
FIG. 4.
FIG. 4.
Forest plot of the meta-analysis illustrating the overall weighted effect size of physical therapy versus control on pain in patients with scar tissue. The diamond on the bottom of the forest plot represents the overall weighted estimate. CI, confidence interval.
FIG. 5.
FIG. 5.
Forest plot of the meta-analysis illustrating the overall weighted effect size of physical therapy versus control on pigmentation in patients with scar tissue. The diamond on the bottom of the forest plot represents the overall weighted estimate.
FIG. 6.
FIG. 6.
Forest plot of the meta-analysis illustrating the overall weighted effect size of physical therapy versus control on pliability in patients with scar tissue. The diamond on the bottom of the forest plot represents the overall weighted estimate.
FIG. 7.
FIG. 7.
Forest plot of the meta-analysis illustrating the overall weighted effect size of physical therapy versus control on pruritus in patients with scar tissue. The diamond on the bottom of the forest plot represents the overall weighted estimate.
FIG. 8.
FIG. 8.
Forest plot of the meta-analysis illustrating the overall weighted effect size of physical therapy versus control on surface area in patients with scar tissue. The diamond on the bottom of the forest plot represents the overall weighted estimate.
FIG. 9.
FIG. 9.
Forest plot of the meta-analysis illustrating the overall weighted effect size of physical therapy versus control on scar thickness in patients with scar tissue. The diamond on the bottom of the forest plot represents the overall weighted estimate.

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