[Physiotherapeutic Scar Therapy for Large Scars].

Physiotherapeutic Scar Therapy for Large Scars Abstract. Deep dermal defects can result from burns, necrotizing fasciitis, and severe soft tissue trauma. Physiological scar restriction during wound healing becomes increasingly relevant in proportion to the area affected. It is massively restrictive for the general mobility of patients. External mechanical influences (activity or immobilization in everyday life) can cause pronounced scar strands and adhesions to form. Overloading ends in a renewed inflammatory reaction and thus in further restriction. Adequate mechanical stimuli can positively influence the scar tissue. The current state of research does not allow a direct transfer to the clinical treatment of large-area scars. However, the continuous clinical implementation of study results regarding the mechanosensitivity of isolated fibroblasts and the constant adaptation of manual techniques have resulted in an evidence-based foundation for manual scar therapy. Early manual treatment in combination with appropriate compression therapy is important.