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[libribook.com] Traumatic Scar Tissue Management 1st Edition
Clinical ConsiderationOff-loading wound tension, and resultant responses via themechanotransduction pathway, can mitigate hypertrophic scarring andpromote healthy tissue regeneration (Garg et al. 2012). The extent to whichmechanotransduction effects can be influenced by manual methods remainsspeculative. However, there is evidence that alteration of local tissuetension can influence post-traumatic healing via mechanotransductionmediatedchanges in collagenase and TGFβ1 production (Langevin 2006,Tortora et al. 2007, Wipff & Hinz 2009, Chaitow 2014).
Clinical ConsiderationMechanical forces such as stretching tension, shear force, compression,hydrostatic pressure and osmotic pressure can be perceived by two generalclasses of receptors: sensory nerve receptors and receptors associated withthe mechanotransduction signaling system; such as integrins andmechanosensitive ion channel and cytoskeleton receptors (Ogawa 2011).Therefore clinical approaches aimed at attenuating mechanical forces andinfluencing such receptors ought to propel better outcomes in theprevention and treatment of scars.Degrees, Severity and Extent of Traumatic ScarsThe depth, severity, extent of the injury/trauma all factor significantly in thedesigning of safe and effective treatment protocols. Pre-existing health issuescan impair wound healing. Issues such as diabetes, immune suppressingconditions, heart disease and liver or kidney issues should be considered whenevaluating scar management protocol.The normal sequencing of the stages of wound healing, the time taken to fullmaturation and the quality of the end product (i.e. scar) depend on severalfactors (Kania 2012):• Depth of damage• Area of damage• Amount of tissue loss• Previous medical condition(s)• Genetic factors.With burn trauma in particular, there are four standard measurements of wounddepth thereby giving the healthcare professional a better understanding ofmuscles, tendons, ligaments, nerves and a host of other considerations that mayhave been involved in the injury. The four measurements, expressed in degrees,
- Page 436 and 437: Table 5.1Stages of wound healing
- Page 438: Clinical ConsiderationBecause thera
- Page 441 and 442: fibroblast growth factor (FGF), epi
- Page 443 and 444: Clinical ConsiderationDuring wound
- Page 445 and 446: Clinical ConsiderationAlthough the
- Page 447 and 448: Pathophysiological ScarsPathophysio
- Page 450 and 451: Figure 5.3Adapted from Huang et al.
- Page 452 and 453: Pathophysiological considerationFib
- Page 454 and 455: Table 5.2Important pathophysiologic
- Page 456 and 457: According to Klingler (2012):… pa
- Page 458 and 459: Table 5.3Scar types and related ter
- Page 460 and 461: unyielding or pliable and mobile. R
- Page 462 and 463: Prolonged InflammationInflammation
- Page 464 and 465: ImmobilizationThe impact of immobil
- Page 467 and 468: Figure 5.4The fall-out associated w
- Page 469 and 470: Clinical ConsiderationHere we see t
- Page 471 and 472: Pathophysiological ConsiderationAcc
- Page 473 and 474: Pathophysiological ConsiderationNeu
- Page 475 and 476: The diverse biological effects of N
- Page 477 and 478: Clinical ConsiderationCareful appli
- Page 479 and 480: Clinical ConsiderationSome patholog
- Page 481 and 482: Pathophysiological ConsiderationSom
- Page 483 and 484: compressive effect in the keloidal
- Page 485: alterations in the mechanical envir
- Page 489 and 490: Table 5.4Role of neuropeptides (NP)
- Page 491 and 492: Fitch P (2005) Scars of life. Journ
- Page 493 and 494: Langevin HM (2006) Connective tissu
- Page 495 and 496: active scars. Journal of Bodywork a
- Page 497 and 498: trauma.
- Page 499 and 500: Clinical ConsiderationPostsurgical
- Page 501 and 502: following burn injury,bacterial col
- Page 503 and 504: Table 6.1Comparison of scars (Ogawa
- Page 505 and 506: Pathophysiological ConsiderationAcc
- Page 507 and 508: BurnsA burn injury to the skin or o
- Page 510 and 511: Figure 6.1Depth of burn trauma and
- Page 512 and 513: • Stimulate ECM formation• Regu
- Page 514 and 515: Clinical ConsiderationIt has been i
- Page 516 and 517: Clinical ConsiderationMT may be a v
- Page 518 and 519: ThermoregulationThermoregulation (t
- Page 520 and 521: from the tissues and taken up by th
- Page 522 and 523: treatment strategies are difficult
- Page 524 and 525: Clinical ConsiderationSkin rolling
- Page 526 and 527: Sequelae and ComplicationsAdvances
- Page 528 and 529: • Paresthesia - 47%• Arm/should
- Page 530 and 531: breast or around the edge of the ar
- Page 532 and 533: Radiation scarringScar tissue as a
- Page 534 and 535: Implants and painPain of fluctuatin
Clinical Consideration
Off-loading wound tension, and resultant responses via the
mechanotransduction pathway, can mitigate hypertrophic scarring and
promote healthy tissue regeneration (Garg et al. 2012). The extent to which
mechanotransduction effects can be influenced by manual methods remains
speculative. However, there is evidence that alteration of local tissue
tension can influence post-traumatic healing via mechanotransductionmediated
changes in collagenase and TGFβ1 production (Langevin 2006,
Tortora et al. 2007, Wipff & Hinz 2009, Chaitow 2014).
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