![[libribook.com] Traumatic Scar Tissue Management 1st Edition](https://documents.yumpu.com/000/063/506/600/df9a14f39008e2ef6fb6257fe1995653691c6175/78495942476d415367326b574a577143792b587756513d3d/46394161765a55506e2b70345757517872524b7a6d413d3d.jpg?AWSAccessKeyId=AKIAICNEWSPSEKTJ5M3Q&Expires=1726218000&Signature=XksgdL27nNwL4cJfMe17mMYVpoI%3D)
[libribook.com] Traumatic Scar Tissue Management 1st Edition
Radiation scarringScar tissue as a result of a mastectomy or radiation can result in several sideeffects(BreastCancer.org 2015a):• Pain, paresthesia or anesthesia if scar tissue entraps a nerve or nerve receptors• Pathophysiological scar tissue that forms in the space where breast tissue isremoved• Pathophysiological, lumpy scar tissue that forms around a suture (i.e. suturegranuloma)• Changes in breast appearance, scar tissue and fluid retention can make breasttissue feel harder or appear rounder than before surgery and/or radiation.Radiation therapy is a burn from the inside out. When radiation is delivered, itaffects many cells – not only the cancer cells, but normal cells as well. Somecells that are particularly sensitive are those that line small blood vessels. Whenradiation is given, some of these very tiny blood vessels are damaged and,sometimes, destroyed. Some parts of tissue receive less blood supply andbecome fibrotic. And some of that tissue, therefore, is not as well-nourished andas viable as it was in its pre-treatment state. In that case, some of those tissuescan scar. It is not uncommon for the radiation site to remain warm to the touchfor up to 6 months after treatment.The total number of patients who suffer from late effects of radiation therapy hasnot decreased because of the increased total number of patients and bettersurvival rates. Late adverse effects, occurring more than a few months afterirradiation, include the extension and collapse of capillaries, thickening of thebasement membrane, and scar tissue due to loss of peripheral vessels. The maincauses of these late effects are the loss of stromal cells and vascular injury(Karasawa 2014).Implants
Capsular contractureCapsular contracture is a complex inflammatory response to the presence of abiomedical device (e.g. silicone or saline implants, orthopedic prostheses).Diverse cell signaling followed by migration of fibroblasts to the implant surfacewill result in the eventual envelopment of the implant in a fibrous collagencapsule. The fibrous capsule will eventually incapacitate the device (e.g.pacemaker, artificial joint) or capsular contracture can result in compression orsqueezing, distortion, migration, hardness and pain – as is seen with breastimplants (DiEqidio et al. 2014).Capsular contracture is the most common complication following the insertionof breast implants. Within a decade, following implantation approximately 50%of patients will develop capsular contracture, leading to significant morbidityand need for reoperation (Fernandes et al. 2014).Capsular contracture is more common following infection, hematoma, seromaand rupture of the implant shell with subsequent leakage of contents. It is alsomore common with subglandular placement.With breast implants capsular contracture is graded by the Baker scale (Table6.3).Current literature supports that steps taken to attenuate inflammatory responseand subsequent fibroblast migration may be the favored approach to preventingor minimizing capsular contracture. Essentially, capsular contracture displays thecommon features associated with pathological scar formation: pathogeniccollagen bundles (too much, too stiff, incoherent organization) and the presenceof MFBs which are capable of smooth-muscle like contractions.
- Page 481 and 482: Pathophysiological ConsiderationSom
- Page 483 and 484: compressive effect in the keloidal
- Page 485 and 486: alterations in the mechanical envir
- Page 487 and 488: Clinical ConsiderationMechanical fo
- 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 534 and 535: Implants and painPain of fluctuatin
- Page 536 and 537: LymphedemaBreast cancer treatment o
- Page 538 and 539: volume of fluid that accumulates or
- Page 540 and 541: OneTwoThreeCommonly referred to as
- Page 542 and 543: myokinetic chain/myofascial meridia
- Page 544: • Loss of touch sensation• Clum
- Page 548 and 549: Figure 6.3Distribution of nerves in
- Page 550 and 551: include preservation of as much of
- Page 552 and 553: complication is present there is de
- Page 554 and 555: Clinical ConsiderationScar complica
- Page 556 and 557: BreastCancer.org (2015c) Side Effec
- Page 558 and 559: 323-9.Kania A (2012) Scars. In: Dry
- Page 560 and 561: Slemp AE, Kirschner RE (2006) Keloi
- Page 562 and 563: scar tissue, while being mindful of
- Page 564 and 565: Physiological ResponseAs discussed
- Page 566 and 567: • The realization that one is abo
- Page 568 and 569: Stress Response and Stress Hormones
- Page 570 and 571: dissociation and inner shakiness) (
- Page 572: Figure 7.1(A) Summary of the HPA me
- Page 575 and 576: Chronic Stress ResponseChronic stre
- Page 577 and 578: Pathophysiological ConsiderationChr
- Page 579 and 580: Clinical ConsiderationProlonged str
- Page 581 and 582: Psychological Stress and Wound Heal
Radiation scarring
Scar tissue as a result of a mastectomy or radiation can result in several sideeffects
(BreastCancer.org 2015a):
• Pain, paresthesia or anesthesia if scar tissue entraps a nerve or nerve receptors
• Pathophysiological scar tissue that forms in the space where breast tissue is
removed
• Pathophysiological, lumpy scar tissue that forms around a suture (i.e. suture
granuloma)
• Changes in breast appearance, scar tissue and fluid retention can make breast
tissue feel harder or appear rounder than before surgery and/or radiation.
Radiation therapy is a burn from the inside out. When radiation is delivered, it
affects many cells – not only the cancer cells, but normal cells as well. Some
cells that are particularly sensitive are those that line small blood vessels. When
radiation is given, some of these very tiny blood vessels are damaged and,
sometimes, destroyed. Some parts of tissue receive less blood supply and
become fibrotic. And some of that tissue, therefore, is not as well-nourished and
as viable as it was in its pre-treatment state. In that case, some of those tissues
can scar. It is not uncommon for the radiation site to remain warm to the touch
for up to 6 months after treatment.
The total number of patients who suffer from late effects of radiation therapy has
not decreased because of the increased total number of patients and better
survival rates. Late adverse effects, occurring more than a few months after
irradiation, include the extension and collapse of capillaries, thickening of the
basement membrane, and scar tissue due to loss of peripheral vessels. The main
causes of these late effects are the loss of stromal cells and vascular injury
(Karasawa 2014).
Implants
Change language