[libribook.com] Traumatic Scar Tissue Management 1st Edition

CHAPTER 5
Wound healing and scars
Never be ashamed of a scar. It simply means you are stronger than
whatever tried to hurt you
Unknown
Any wound that breaches the dermis results in some degree of scarring, no
matter how the wound occurred (Fitch 2005). Scar formation – a natural
biological process – is the body’s means by which it protects itself from
infection and re-establishes structural continuity by knitting itself back together
following injury or trauma.
Although the ‘replacement-tissue’ that forms the scar differs from the original
tissue, normal or healthy scarring is intended to restore or preserve tissue
integrity and function. On the other hand, if any aspect of the process is faulty or
mismanaged, pain and dysfunction can occur at debilitating levels. Both normal
(physiological) and abnormal (pathophysiological) scars are covered in this
chapter.
The aim of this chapter is to provide a solid base for understanding and working
with tissue that is a little out of the ordinary. Although each client’s physiology
may differ from the next, there are enough similarities between individuals to
inform treatment protocol and to effect positive changes. In some cases,
treatment may not significantly impact scar aesthetics or scar tissue structural
organization; however, there is evidence to support the claim that manual scar
management techniques can impact pain, function and quality of life in positive
and productive ways (DeNoon 2005, Josenhans 2007, Cherkin 2011, Bove &
Chapelle 2012, Fourie 2008, 2009, 2012, Werner 2012, Rodriguez & del Rio
2013).