SCAR TISSUE

Question 1

History questions?

Answer 1

1. When did the injury happen?
2. Cleared by MD?
3. Modality
4. Did it blister or did the skin stay intact?
5. How long was the exposure to heat?

Question 2

Contraindications?

Answer 2

1. Frictions are CI if the clt is taking anti-inflammatory medication
2. Frictions are not recommended for proud flesh or keloid scars
3. Avoid direct contact if blistered or open wounds (wear gloves to avoid infection)
4. Overstretching skin around infected area (stroke direction towards wound)
5. Avoid Heat with immature or reduced sensation scars

Question 3

Treatment goals?

Answer 3

1. Freeing restriction fibrous bands and increase circulation to soften scar tissue
2. Desensitize hypersensitive scars to assist relaxing and decrease pain
3. Decrease edema to reduce the amount of scar tissue that develops
4. Soften scar tissue to increase ROM

Question 4

Treatment Protocol?

Answer 4

Late Subacute - Chronic:
1. Hydrotherapy: heat (parafin wax, hydrocollator) w maturing scar
2. Assessment start palpation: skin rolling, fascial glide
3. Swedish eff warm up
4. Mm striping (O+I direction // fibre direction
5. Cross fibre friction
6. Mm stripping realignment
7. Reassess w fascial gliding
8. Stretch (assisted or not)
9. Flush out w eff
10. Apply cold

Question 5

Home care?

Answer 5

1. Apply techniques 6 times daily, 10-15min at a time
2. Pain free movement as soon as possible
   prolonged passive self-stretching in late subacute
3. Submaximal isometric contractions in early subacute
4. Increasing in force in late subacute stage isotonic
5. Strengthening antagonist mm

Question 6

Hot Hydro ?

Answer 6

Treatment:
1. Ask for consent to undrape
2. Undrape and get visual on it
3. Hot treatment explanation
4. Heat treatment consent
5. Pillow support
6. Clean towel
7. Warm pad
8. Check pain scale
9. Massage unaffected side
10. Removal
HOMECARE:
1. Modality (heat pad/arm and foot bath/hot towels/full body bath/ shower ect
2. Temp (36-38 warm, >39 hot)
3. Where to apply it (body part)
4. How long to apply it for (10-15 minutes)
5. Frequency (How many times a day)
6. For how long (days/weeks)
7. Precautions + CBAN
8. CI’s

Question 7

Cold Hydro ?

Answer 7

I. Cold hydro:
Treatment:
1. Ask for consent to undrape
2. Undrape and get visual on it
3. CBAN explanation
4. Cold treatment consent
5. Pillow support
6. Clean towel
7. Cold pad
8. Check pain scale + CBAN
9. Massage unaffected side
10. Ask if they feel numb, REMOVE
11. If they don’t feel numb, REMOVE after 5 minutes
HOMECARE:
1. Modality (ice pack/frozen towel/ shower ect
2. Temp (0-12 cold/13-18 cool)
3. Where to apply it (body part)
4. How long to apply it for
5. Frequency (How many times a day)
6. For how long (days/weeks)
7. Precautions + CBAN
8. CI’s

Question 8

8 Types of Scar Tissue ?

Answer 8

1. Contracture
2. Adhesion
3. Scar tissue adhesion
4. Fibrotic adhesion
5. Irreversible contracture
6. Proud flesh
7. Hypertrophic scarring
8. Keloid