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[libribook.com] Traumatic Scar Tissue Management 1st Edition
Scar ChronologyThe wound healing process begins at the time of the injury and may take up to 2years to complete (Kania 2012). Subsequent chapters will cover how MT canassist in a long-term recovery plan for your client.Scar chronology is broken down into immature and mature (Goel & Shrivastava2010), with the identifiable presentations of each noted as follows:Immature:• <1 year old• Thick and firm• Elevated or raised in height• Not easily pliable• Red or pinkish in color• Blanches with pressure.Mature:• >1 year old• Soft• Flat• Pliable• Displays normal vascularity (does not blanch).
Pathophysiological ScarsPathophysiological scars are generally accepted to be the result of prolonged,aberrant wound healing that involves excessive fibroblast participation andcollagen deposition (Huang et al. 2013) – see Figure 5.3. Regardless of etiologyand size, pathophysiological scars will display characteristics that differ fromnormal skin, viscera and fascia in the following ways:• Are thickened, dense• Display textural variations (e.g. rough, lumpy, dimpled, puckered)• Tend to exhibit compromised elasticity and mobility• May display altered or abnormal neuro-functioning (hypersensitivity,hyposensitivity, increased electrical activity with movement) (Bordoni &Zanier 2014, Valouchová & Lewit 2009)• Some mature scars may be pale due to limited blood supply or appear reddishdue to hypervascularization that lasts beyond the ‘normal’ time frame (i.e.early stage of wound healing).
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- Page 432 and 433: CHAPTER 5Wound healing and scarsNev
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- Page 436 and 437: Table 5.1Stages of wound healing
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- Page 454 and 455: Table 5.2Important pathophysiologic
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Pathophysiological Scars
Pathophysiological scars are generally accepted to be the result of prolonged,
aberrant wound healing that involves excessive fibroblast participation and
collagen deposition (Huang et al. 2013) – see Figure 5.3. Regardless of etiology
and size, pathophysiological scars will display characteristics that differ from
normal skin, viscera and fascia in the following ways:
• Are thickened, dense
• Display textural variations (e.g. rough, lumpy, dimpled, puckered)
• Tend to exhibit compromised elasticity and mobility
• May display altered or abnormal neuro-functioning (hypersensitivity,
hyposensitivity, increased electrical activity with movement) (Bordoni &
Zanier 2014, Valouchová & Lewit 2009)
• Some mature scars may be pale due to limited blood supply or appear reddish
due to hypervascularization that lasts beyond the ‘normal’ time frame (i.e.
early stage of wound healing).
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