Physiotherapy Modalities in Wound Management

Physical scar management represents an important field in science, as scars can negatively impact the quality of life of patients. Disturbing perceptions such as pain, tenderness or itchiness on the one hand, and functional limitations in the form of contractures on the other, are consequences of problematic scars. In addition, scar esthetics can also have a negative influence on psychosocial factors. The restoration of injured skin requires a complex sequence of physiological interactions to form appropriate scar tissue and repair the dermal lesion. Any dysfunction in the wound healing process may result in excessive scar tissue formation. Hypertrophic scars or keloids are the results of such deviant wound healing. Different therapy options, described in the literature include chemical, physical, and surgical methods. The physiotherapist focuses on conservative modalities in the treatment of scar tissue. These physical scar management options can be grouped into mechanotherapy, occlusive and hydrogenatic therapies, light therapy, laser therapy (low level, high power), photodynamic therapy, or electrical stimulation, among others, whereby often combinations are used. The purpose of physical scar management concentrates primarily on the prevention of an aberrant healing process of the skin. Physical therapy is present in daily clinical consultations and has demonstrated a certain utility in wound healing. Physiotherapy arises as a possible safe complementary treatment that might improve the results of the traditional treatment. Physiotherapy has been demonstrated to improve tissue healing with different grades or evidence; however, further studies are necessary to develop practical protocols in clinical practice based on the theoretical mechanism of action of the therapy.