In order to be able to assess the scar and apply the appropriate therapy, the correct diagnostic tools must be used for this purpose. The physiotherapist looks at the scar and assesses it according to the following criteria:
- scar mass: length, width, thickness,
- texture: softness, irregularity,
- outline: flat, convex, concave scar,
- pigmentation: absence of pigmentation, comparison with surrounding skin,
- structure, elasticity: comparison with surrounding skin,
- function: restriction of mobility, tension,
- sensitivity: disturbance or absence of sensation, pain,
- activity: progressive development, growth arrest,
Sometimes the resulting scar may cause pain, itching or extend beyond the wound edges. There are the following types of scar:
- normal scar – bright and flat (not extending beyond the surrounding skin),
- abnormal scar – red, itchy or painful, slightly raised above the surrounding skin; many such scars become flat over time and take on a skin-like colouring,
- linear hypertrophic scar – red, slightly elevated, occasionally itchy or painful, not extending beyond the outline of the surgical wound,
- large-area hypertrophic scar – planar, convex, sometimes itchy (e.g. burn scar),
- small keloid – limited, convex, itchy scar, extending beyond the outline of the wound; may develop a year after formation and does not regress spontaneously,
- large keloid – large convex scar, more than 0.5 cm in diameter, painful or itchy, extending beyond the outline of the wound, may grow over many years.
Antonina Kaczorowska
References:
- Bordoni BD, Zanier E. Terapia manualna blizny. Wydawnictwo PZWL. 2020
- Chochowska M. Praca z blizną po operacji cesarskiego cięcia. Rehabilitacja w praktyce 2018; 5: 36-42.
- Drozd A, Nowacka-Kłos M, Szamotulska J, Hansdorfer-Korzon R. Możliwości zastosowania terapii manualnej w obszarze blizny. Rehabilitacja w praktyce 2021; 4: 34-42.
- Witmanowski H, Zieliński T, Łuczkowska M i wsp. Blizny przerostowe i keloidy, Część I. Patogeneza i mechanizm powstawania. Post Dermatol Alergol 2008; 25,3:107-115.
