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

Clinical Consideration
It has been identified that mechanical forces can induce changes in the
expression of ECM proteins and proteases. In a study by Kanazawa et al.
(2009), it was revealed that uniaxial, cyclical stretching of skin fibroblasts
resulted in down-regulation of agents known to stimulate persistent
collagen proliferation associated with fibrosis and abnormal scarring. In
another in vitro model, human hypertrophic scar samples responded to
mechanical loading by inducing apoptosis (Derderian et al. 2005).
Although the exact mechanism remains to be determined, it is
hypothesized that massage can impact cellular structural and signaling
milieu, thereby inducing beneficial effects through the ability to affect
fibroblast apoptosis and remodeling (Bhadal et al. 2008, Chan et al. 2010,
Cho et al. 2014).