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

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unyielding or pliable and mobile. Remodelling is not (necessarily)restricted to the injured area. Neighboring, non-injured tissue also changesits collagen production rate in response to inflammation.Fourie 2012

Pathophysiological ConsiderationIn his exploration of the tendon sliding system, Guimberteau noted, at theFRC III 2012, that when – certain – tendons move, the movement is barelydiscernible in neighboring tissues if no restrictions are present (e.g.adhesions, fibrosis). According to Guimberteau, variances in non-injuredtissue and tissue during and after scar formation can be seenendoscopically. Notably, with irregular or abnormal healing (even thoughthe surface tissue looks normal) below the surface undifferentiated tissuecan be present for several months (e.g. thick/dense and devoid of loosesliding tissue). Additionally, the hypervasculization typically seen in theearly stages of normal healing will persist far longer with abnormal orirregular healing. When reconstructive hardware is used (e.g. screws,plates, and synthetic joint parts) normal scar formation does not occur.Generally speaking, the greater the damage, the more extensive the scarring andthe more extensive the abnormal scarring, greater is the potential for functionalloss or abnormal functioning (e.g. dermal scars are less resistant to ultravioletradiation, hair follicles do not grow back within scar tissue and extensive cardiacmuscle scarring can lead to heart failure). Altered or abnormal healing increasesthe likelihood of excessive scarring (adherences), which in turn can impact thefunctioning of various tissues and systems.Pathological scars in skin and fascia alter not only the structure and functioningof these tissues but also impacts the individual and their body’s capacity tointeract with his/her internal and external environment.Prolonged Inflammation and ImmobilizationInflammatory response is our body’s natural/normal process of repair followinginjury. If all goes well, undue damage does not typically occur and the eventculminates in a positive resolution (e.g. tissue healing, normal repair/remodelingand recovery of pain-free function). However, the fall-out from excessive orprolonged inflammation and immobilization constitutes some of the mostprevailing issues we may deal with in our practice.

unyielding or pliable and mobile. Remodelling is not (necessarily)

restricted to the injured area. Neighboring, non-injured tissue also changes

its collagen production rate in response to inflammation.

Fourie 2012

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