[libribook.com] Traumatic Scar Tissue Management 1st Edition
Clinical ConsiderationThe ECM is a bioactive structure that controls cell behavior throughchemical and mechanical signals. Multiple studies have revealed that ECMcontrols organ and tissue development and subsequent function throughcell anchorage; integrin-mediated activation and signaling; transduction ofmechanical forces; and the sequestering, release and activation of growthfactors. A better understanding of how the ECM and its mechanical forcescan affect cell invasion, growth and differentiation, and the ECM’scapacity to manipulate and direct fundamental cell functions and to applythis knowledge to tissue growth and repair, will be a cornerstone forfurthering the fields of wound care and scar management (Discher et al.2009, Hynes 2009, Gilbert et al. 2010, Dupont et al. 2011, Eming et al.2014).
Clinical ConsiderationPreventive measures are a major priority and need to be applied before,during and immediately after wound closure. Reducing mechanical tensionin and around the scar is a significant consideration in terms of preventionof contractures, hypertrophic and keloid scars. Medical treatment ofpathophysiological scars includes removal of the bulky scar tissue byreconstructive surgical techniques and/or injection of substances, such ascollagenase, that promote collagen breakdown (Monstrey et al. 2014).Recall from Chapter 5: during wound healing, continuous or cyclicalloading (brief, light stretch or compression – lengthening <30%) ofmechanosensitive tissues stimulates resident fibroblasts to secretecollagenase (Tortora et al. 2007) reducing the potential of excess collagenformation (fibrosis and pathological cross-linking). Cyclicalstretch/compression – involving approximately 10% of available tissueelasticity – doubles collagenase production, whereas continuous stretchingappears to be 50% less productive (Carano & Siciliani 1996, Langevin2010). And repeated, low amplitude tissue stretch seems to elicit an antiinflammatoryresponse (Yang et al. 2005).
- Page 697 and 698: Scar scalesScar scales can be used
- Page 699 and 700: response to negative pressure. It h
- Page 701 and 702: • Client self-management strategi
- Page 703 and 704: BindOnce barrier is reached or surp
- Page 705 and 706: Table 9.1Comparative of normal and
- Page 707 and 708: 2-3 times a year effectively addres
- Page 709 and 710: Myofascial meridian exampleSuperfic
- Page 711: Clinical ConsiderationKnee and back
- Page 715 and 716: Clinical ConsiderationApplication t
- Page 717 and 718: Pathophysiological ConsiderationMec
- Page 719 and 720: Clinical ConsiderationStecco and co
- Page 721 and 722: Safety FirstMT appears to have few
- Page 723 and 724: Deep workThe deep techniques noted
- Page 725 and 726: Psychological considerationsIt is w
- Page 727 and 728: Clinical ConsiderationMT dosage and
- Page 729 and 730: Developing a sound treatment strate
- Page 731 and 732: Treatment outcomesEssentially, earl
- Page 733 and 734: Dosage considerationsThe presence o
- Page 735 and 736: Clinical ConsiderationNumerous syst
- Page 737 and 738: Clinical ConsiderationHeat in the t
- Page 739 and 740: Clinical ConsiderationBest and co-w
- Page 741 and 742: Pathophysiological considerationCom
- Page 743 and 744: Clinical ConsiderationTiming is eve
- Page 745 and 746: Clinical ConsiderationEvidence sugg
- Page 747: Clinical ConsiderationSeveral studi
- Page 751 and 752: Pathophysiological ConsiderationWit
- Page 753 and 754: TechniquesCommonly employed techniq
- Page 755 and 756: Treatment outcomesThe later stages
- Page 757 and 758: Clinical ConsiderationsNon-threaten
- Page 759 and 760: Clinical ConsiderationsIt has been
- Page 761 and 762: Clinical ConsiderationsMT may be a
- Page 763 and 764: Pathophysiological ConsiderationUnd
- Page 765 and 766: Clinical ConsiderationsIn the early
- Page 767 and 768: Clinical ConsiderationsAs the remod
- Page 769 and 770: Treatment outcomesEssentially, the
- Page 771 and 772: Dosage considerationsThe presence o
- Page 773 and 774: TechniquesAny carpenter will tell y
- Page 775 and 776: Pressure Level 4 - Strong pressure/
- Page 777 and 778: Grade 7 and 8• Firm, deep• Trig
- Page 779 and 780: Neutralize pHFacilitate healing pro
- Page 781 and 782: Manual Lymphatic TechniquesEarly ma
- Page 783 and 784: Table 9.4Treatment guideline summar
- Page 785 and 786: Clinical ConsiderationEdema, excess
- Page 788 and 789: Figure 9.2Half-moon/circles: cleari
- Page 791 and 792: Figure 9.3Pumping: clearing the ext
- Page 793: RotaryThe rotary technique is commo
- Page 797: Figure 9.5Rotary (thorax). Half-moo
Clinical Consideration
The ECM is a bioactive structure that controls cell behavior through
chemical and mechanical signals. Multiple studies have revealed that ECM
controls organ and tissue development and subsequent function through
cell anchorage; integrin-mediated activation and signaling; transduction of
mechanical forces; and the sequestering, release and activation of growth
factors. A better understanding of how the ECM and its mechanical forces
can affect cell invasion, growth and differentiation, and the ECM’s
capacity to manipulate and direct fundamental cell functions and to apply
this knowledge to tissue growth and repair, will be a cornerstone for
furthering the fields of wound care and scar management (Discher et al.
2009, Hynes 2009, Gilbert et al. 2010, Dupont et al. 2011, Eming et al.
2014).