Use of tape for the management of hypertrophic scar development: A comprehensive review

Sarah O'Reilly, Erin Crofton, Jason Brown, Jennifer Strong, Jenny Ziviani, Sarah O'Reilly, Erin Crofton, Jason Brown, Jennifer Strong, Jenny Ziviani

Abstract

Introduction: Tapes have been used to aid fresh wound closure. For hypertrophic scars, the use of tapes as a therapy to reduce the mechanical forces that stimulate excessive and long-term scarring is yet to be evaluated. The aim of this comprehensive review was to explore the current clinical application of tapes, as a minimally invasive option, as purposed specifically for the management of hypertrophic scarring, regardless of scar causation.

Method: Databases were searched using MeSH terms including one identifier for hypertrophic scar and one for the intervention of taping. Studies included the following: patients who received tape for a minimum of 12 weeks as a method of wound closure specifically for the purpose of scar prevention; those who received tape as a method of scar management after scar formation; reported outcomes addressing subjective and/or objective scar appearance; and were available in English.

Results: With respect to non-stretch tapes, their use for the prevention of linear surgical scarring is evident in reducing scar characteristics of height, colour and itch. Statistically significant results were found in median scar width, reduction in procedure times and overall scar rating. Tapes were predominately applied by participants themselves, and incidence of irritation was infrequently reported. After 12 months, significance with respect to scar pain, itch, thickness and overall scar elevation was reported in one study investigating paper tape. Two papers reported the use of high stretch tapes; however, subjective results limited formal analysis. Although the use of taping for abnormal hypertrophic scar management is in its infancy, emerging research indicates tapes with an element of stretch may have a positive impact.

Conclusions: Non-stretch tapes, for the prevention of linear surgical scarring, are effective in reducing scar characteristics of height, colour and itch. Paper tapes have shown effectiveness when applied during wound remodelling or even on mature scarring, with reported subjective changes in scar colour, thickness and pliability. Preliminary evidence of the benefits of high-stretch, elasticised tapes for scar management in the remodelling phase of wound healing have also been reported.

Lay summary: Patients are often concerned about unsightly scars that form on their bodies after trauma, especially burn injuries. These scars can be thick, red and raised on the skin, and can impact on the patient's quality of life. For some scars, the process of skin thickening continues for up to two years after an injury.Unfortunately, scar formation is a part of the body's healing process, whereby there is a constant pull or tension under and along the skin's surface. The use of simple tapes, such as microporetm, to help with wound closure are sometimes used as a therapy to reduce the tension on the skin's surface when a wound is healing to minimise scar formation. However, the effectiveness of taping has not been proven. This paper looks at the available evidence to support the use of taping to reduce scar features of height, thickness and colour. Initial evidence of mixed levels, suggests some benefits of tapes for scar management and show preliminary efficacy for reduction of scar height, thickness and colour. More research is required to determine the direct impact, comparison to other treatments available and patient viewpoint for this therapy.

Keywords: cicatrix; review; scar; tape.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

© The Author(s) 2021.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram. Please swap over the figures.
Figure 2.
Figure 2.
Early application clinical guide.
Figure 3.
Figure 3.
Late tape application clinical guide.

References

    1. Monstrey S, Middelkoop E, Vranckx JJ, et al.. Updated Scar Management Practical Guidelines: Non-invasive and invasive measures. J Plast Reconstr Aesthet Surg 2014; 67(8): 1017–1025.
    1. Young VL, Hutchison J. Insights into patient and clinician concerns about scar appearance: semiquantitative structured surveys. Plast Reconstr Surg 2009; 124(1): 256–265.
    1. Sund B. New developments in wound care. London: PJB Publications, 2000.
    1. Bayat A, McGrouther DA, Ferguson MWJ. Skin scarring. BMJ 2003; 326(7380): 88–92.
    1. Barnes LA, Marshall CD, Leavitt T, et al.. Mechanical forces in cutaneous wound healing: emerging therapies to minimize scar formation. Adv Wound Care 2018; 7(2): 47–56.
    1. Wong VW, Akaishi S, Longaker MT, et al.. Pushing back: wound mechanotransduction in repair and regeneration. J Invest Dermatol 2011; 131(11): 2186–2196.
    1. Arno AI, Gauglitz GG, Barret JP, et al.. Up-to-date approach to manage keloids and hypertrophic scars: a useful guide. Burns J Int Soc Burn Inj 2014; 40(7): 1255–1266.
    1. Atkinson J-AM, McKenna KT, Barnett AG, et al.. A randomized, controlled trial to determine the efficacy of paper tape in preventing hypertrophic scar formation in surgical incisions that traverse Langer’s skin tension lines. Plast Reconstr Surg 2005; 116(6): 1648–1656; discussion 1657–1658.
    1. Widgerow AD, Chait LA, Stals R, et al.. New innovations in scar management. Aesthetic Plast Surg 2000; 24(3): 227–234.
    1. Seifert O, Mrowietz U. Keloid scarring: bench and bedside. Arch Dermatol Res 2009; 301(4): 259–272.
    1. Toscano D, Arena D, Stella M, et al.. Application of the TNM on Burn Scars: Integration with the Rehabilitation Protocol of the CTO of Turin - Clinical Case. 2016. Available at: (accessed 20 November 2020).
    1. Wong VW, Rustad KC, Akaishi S, et al.. Focal adhesion kinase links mechanical force to skin fibrosis via inflammatory signaling. Nat Med 2011; 18(1): 148–152.
    1. Aarabi S, Bhatt KA, Shi Y, et al.. Mechanical load initiates hypertrophic scar formation through decreased cellular apoptosis. FASEB J 2007; 21(12): 3250–3261.
    1. Duscher D, Maan ZN, Wong VW, et al.. Mechanotransduction and fibrosis. J Biomech 2014; 47(9): 1997–2005.
    1. Costa AM, Peyrol S, Porto LCP, et al.. Mechanical Forces Induce Scar Remodeling. Am J Pathol 1999; 155: 1671–1679.
    1. Chiang RS, Borovikova AA, King K, et al.. Current concepts related to hypertrophic scarring in burn injuries. Wound Repair Regen 2016; 24(3): 466–477.
    1. Chiquet M, Gelman L, Lutz R, et al.. From mechanotransduction to extracellular matrix gene expression in fibroblasts. Biochim Biophys Acta 2009; 1793: 911–920.
    1. Kia KF, Burns MV, Vandergriff T, et al.. Prevention of scar spread on trunk excisions: a rater-blinded randomized controlled trial. JAMA Dermatol 2013; 149(6): 687–691.
    1. Meyer M, McGrouther DA. A study relating wound tension to scar morphology in the pre-sternal scar using Langers technique. Br J Plast Surg 1991; 44: 291–294.
    1. Ogawa R, Okai K, Tokumura F, et al.. The relationship between skin stretching/contraction and pathologic scarring: the important role of mechanical forces in keloid generation. Wound Repair Regen 2012; 20(2): 149–157.
    1. Rustad KC, Wong VW, Gurtner GC. The role of focal adhesion complexes in fibroblast mechanotransduction during scar formation. Differentiation 2013; 86(3): 87–91.
    1. Widgerow AD. Current concepts in scar evolution and control. Aesthetic Plast Surg 2011; 35(4): 628–635.
    1. Widgerow AD, Chait LA. Scar management practice and science: a comprehensive approach to controlling scar tissue and avoiding hypertrophic scarring. Adv Skin Wound Care 2011; 24(12): 555–561.
    1. Rosengren H, Askew DA, Heal C, et al.. Does taping torso scars following dermatologic surgery improve scar appearance? Dermatol Pract Concept 2013; 3(2): 75–83.
    1. Longaker MT, Rohrich RJ, Greenberg L, et al.. A randomized controlled trial of the embrace advanced scar therapy device to reduce incisional scar formation. Plast Reconstr Surg 2014; 134(3): 536–546.
    1. Moortgat P, Van Daele U, Anthonissen M, et al.. Tension Reducing Taping as a Mechanotherapy for Hypertrophic Burn Scars - A Proof of Concept. Annals of Burns and Fire Disasters 2015. DOI: 10.13140/RG.2.1.2961.4564.
    1. Profyris C, Tziotzios C, Do Vale I. Cutaneous scarring: Pathophysiology, molecular mechanisms, and scar reduction therapeutics Part I. The molecular basis of scar formation. J Am Acad Dermatol 2012; 66(1): 1–10; quiz 11–2.
    1. Agha R, Ogawa R, Pietramaggiori G, et al.. A review of the role of mechanical forces in cutaneous wound healing. J Surg Res 2011; 171(2): 700–708.
    1. Mustoe TA, Cooter RD, Gold MH, et al.. International clinical recommendations on scar management. Plast Reconstr Surg 2002; 110(2): 560–571.
    1. Bush JA, Ferguson MWJ, Mason T, et al.. Skin tension or skin compression? Small circular wounds are likely to shrink, not gape. J Plast Reconstr Aesthet Surg 2008; 61(5): 529–534.
    1. Rhett JM, Ghatnekar GS, Palatinus JA, et al.. Novel therapies for scar reduction and regenerative healing of skin wounds. Trends Biotechnol 2008; 26(4): 173–180.
    1. Tollefson TT, Kamangar F, Aminpour S, et al.. Comparison of effectiveness of silicone gel sheeting with microporous paper tape in the prevention of hypertrophic scarring in a rabbit model. Arch Facial Plast Surg 2012; 14(1): 45–51.
    1. Levi K, Ichiryu K, Kefel P, et al.. Mechanics of wound closure: emerging tape-based wound closure technology vs. traditional methods. Cureus 2016; 8(10): e827.
    1. Reiffel RS. Prevention of hypertrophic scars by long-term paper tape application. Plast Reconstr Surg 1995; 96(7): 1715–1718.
    1. Karwacińska J, Kiebzak W, Stepanek-Finda B, et al.. Effectiveness of Kinesio Taping on hypertrophic scars, keloids and scar contractures. Pol Ann Med 2012; 19(1): 50–57.
    1. Gurtner GC, Dauskardt RH, Wong VW, et al.. Improving cutaneous scar formation by controlling the mechanical environment: large animal and phase I studies. Ann Surg 2011; 254(2): 217–225.
    1. Wong VW, Longaker MT, Gurtner GC. Soft tissue mechanotransduction in wound healing and fibrosis. Semin Cell Dev Biol 2012; 23(9): 981–986.
    1. Huang Y, Chang K, Liou T, et al.. Effects of Kinesio taping for stroke patients with hemiplegic shoulder pain: a double-blind, randomized, placebo-controlled study. J Rehabil Med 2017; 49(3): 208–215.
    1. Daya M. Abnormal scar modulation with the use of micropore tape. Eur J Plast Surg 2011; 34(1): 45–51.
    1. Chen HH, Tsai WS, Yeh CY, et al.. Prospective study comparing wounds closed with tape with sutured wounds in colorectal surgery. Arch Surg 2001; 136(7): 801–803.
    1. Kim H, Kim J, Choi J, et al.. The Usefulness of Leukosan SkinLink for Simple Facial Laceration Repair in the Emergency Department. Arch Plast Surg 2015; 42(4): 431–437.
    1. Doumit J, Vale R, Kanigsberg N. Dynaclose tape: a practical alternative to punch biopsy site closure. J Cutan Med Surg 2013; 17(1): 62–65.
    1. Widgerow AD, Chait LA, Stals PJ, et al.. Multimodality Scar Management Program. Aesthetic Plast Surg 2009; 33(4): 533–543.
    1. Custis T, Armstrong AW, King TH, et al.. Effect of Adhesive Strips and Dermal Sutures vs Dermal Sutures Only on Wound Closure: A Randomized Clinical Trial. JAMA Dermatol 2015; 151(8): 862.
    1. van de Gevel DFD, Hamad MAS, Elenbaas TWO, et al.. Is the use of Steri-StripTM S for wound closure after coronary artery bypass grafting better than intracuticular suture? Interact Cardiovasc Thorac Surg 2010; 10(4): 561–564.
    1. Yang S, Ozog D. Comparison of Traditional Superficial Cutaneous Sutures Versus Adhesive Strips in Layered Dermatologic Closures on the Back-A Prospective, Randomized, Split-Scar Study. Dermatol Surg 2015; 41(11): 1257–1263.
    1. Zempsky WT, Parrotti D, Grem C, et al.. Randomized controlled comparison of cosmetic outcomes of simple facial lacerations closed with Steri Strip (TM) skin closures or Dermabond (TM) tissue adhesive. Pediatr Emerg Care 2004; 20(8): 519–24.
    1. van de Kar AL, Koolbergen DR, van Avendonk JPH, et al.. Comparison of wound closure techniques in median sternotomy scars in children: subcuticular suture versus Steri-StripTM S. J Plast Surg Hand Surg 2019; 53(3): 161–166.
    1. Crofton E, Meredith P, Gray P, et al.. Non-adherence with compression garment wear in adult burns patients: A systematic review and meta-ethnography. Burns 2020; 46(2): 472–482.
    1. Coghlan N, Copley J, Aplin T, et al.. Patient Experience of Wearing Compression Garments Post Burn Injury: A Review of the Literature. J Burn Care Res 2017; 38(4): 260–269.
    1. Coghlan N, Copley J, Aplin T, et al.. How to improve compression garment wear after burns: Patient and therapist perspectives. Burns 2019; 45(6): 1447–1455.
    1. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998; 52(6): 377–384.
    1. Sawada Y, Nihei Y, Urushidate S. Hydration and occlusion treatment for grafted skin on the hands of children. Eur J Plast Surg 1998; 21(7): 349–352.
    1. Lin Y-S, Ting P-S, Hsu K-C. Comparison of Silicone Sheets and Paper Tape for the Management of Postoperative Scars: A Randomized Comparative Study. Adv Skin Wound Care 2020; 33(6): 1–6.
    1. Spieth PM, Kubasch AS, Penzlin AI, et al.. Randomized controlled trials – a matter of design. Neuropsychiatr Dis Treat 2016; 12: 1341–1349.
    1. Pannucci CJ, Wilkins EG. Identifying and Avoiding Bias in Research. Plast Reconstr Surg 2010; 126(2): 619–625.
    1. Pearson A, Wiechula R, Court A, et al.. The JBI model of evidence-based healthcare. Int J Evid Based Healthc 2005; 3(8): 207–215.
    1. Crofton E, Meredith P, Gray P, et al.. Compression garment wear post-burn: measurement of how I “feel” through quantitative and self-report sensory variables impacts upon wear, a single-site study. Burns 2020; 46(8): 1903–1913.
How to cite this article
    1. O’Reilly S, Crofton E, Brown J, Strong J, Ziviani J. Use of tape for the management of hypertrophic scar development: A comprehensive review. Scars, Burns & Healing, Volume 7, 2021. DOI: 10.1177/ 20595131211029206.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться