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

hongchingyee
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16.06.2020 Views

According to Klingler (2012):… painful contractures resulting in limited/reduced range of motion are often associated withrigid collagenous tissue within and surrounding skeletal muscle, as well as other CTs involvedin force transmission (e.g. retinaculae, thoracolumbar fascia, tendon).HypertrophicscarKeloid scarAtrophic scarWidespreadscarAn elevated, excessive scar that is limited to the original boundaries of the incision or wound(Bordoni & Zanier 2014, Zhu et al. 2013). Common features include raised, thickened, red andsometimes ropelike scarring. Hypertrophic scars can lead to deformity, disfigurement and loss offunction and can take weeks to form. Scars formed at the fringe of skin grafts are prone tohypertrophy (e.g. those associated with deep second-degree burns and other scars requiring grafts).Both hypertrophic and keloid scars occur more commonly in the regions of the anterior chest,shoulder/periscapular, lower abdomen and ear lobes (Ogawa 2008, Bordoni & Zanier 2014) (seeFig. 5.1)An abnormal scar that forms at the site of an injury or an incision and spreads beyond the bordersof the original lesion. The scar is made up of a swirling mass of collagen fibers and fibroblasts.Keloid scars reach out like little fingers and extend well beyond the original injured area. Commonfeatures include thickened, raised, itchy clusters of scar tissue that grow beyond the edges of thewound or incision and are often red or darker in color than surrounding skin. Keloids occur whenthe body continues to produce the tough, fibrous collagen after a wound has healed. Keloids mostcommonly appear over the sternum, ears and shoulders and occur more in dark-skinned people.The tendency to develop keloid scars lessons with age. Some scars may start as hypertrophic andeventually develop into keloid (see Fig. 5.2)Common presentation is a fibrotic, cutaneous depression displaying a sunken or pitted appearance(Weiss et al. 2010)Can appear when the fine lines of surgical scars gradually become stretched and widened. Thesetypically flat, pale, soft, symptomless scars are more common following knee or shoulder surgery(Rudolph 1987). Stretch marks (abdominal striae) are variants of widespread scars involving injuryto the dermis and subcutaneous tissues without breaching the epidermis. There is no elevation,thickening, or nodularity in mature widespread scars, which distinguishes them from hypertrophicscars (Bayat et al. 2003)

Clinical ConsiderationAs discussed previously; if tensional homeostasis can be achieved/restored, thereby mediating superfluous collagenproliferation, it seems plausible that the risk of pathophysiological scarring can be reduced

Clinical Consideration

As discussed previously; if tensional homeostasis can be achieved/restored, thereby mediating superfluous collagen

proliferation, it seems plausible that the risk of pathophysiological scarring can be reduced

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