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

Palpation
Palpation assessment ought to include the scar itself and surrounding and
associated tissue. Often certain local observations are made along with palpation.
A method of tracking progress is to measure and document palpable and
observable pre-treatment presentations and post-treatment changes. Palpation
assessment includes soft tissue barrier evaluation (covered in more detail later in
this chapter).
Scar Assessment and Evaluation
When assessing the scar itself, note what the scar feels like – is it smooth, rough,
lumpy, hard, pliable, stiff? Is the tissue mobile, pliable, dense or thickened?
Upon challenge does the nearby tissue dimple or pucker; can strain be seen in
nearby or distant tissues? Is the scar region tender, sensitive?
Scar evaluation and documentation considerations include:
• Age of the scar (mature, immature)
• Location of the scar (near/across joint margins, visible/hidden by clothing)
• Incision line features (thick or thin, linear or tortuous)
• Feel of the scar (lumpy, elevated, hard, thickened)
• Scar color/discoloration (e.g. redness or blanching/banding with stretch and
movement)
• Scar temperature (hot, warm, cold)
• Scar and surrounding tissue pliability, mobility
• Strain exerted on surrounding tissue
• Any pain associated with the scar (local and referred)
• Pruritus.
Standardized, valid and reliable assessment tools (measurement instruments) can
be utilized to assist the MT with monitoring changes in scar quality and
evaluating the effectiveness of treatment (see Box 9.3).