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Is massage an effective intervention in the management of post-operative scarring? A scoping review

Published:February 25, 2022DOI:https://doi.org/10.1016/j.jht.2022.01.004

      Highlights

      • Research into scar massage following surgery is heterogenous in nature.
      • Scar massage may improve scar characteristics, reduce pain and increase movement.
      • There is a lack of consistency in how scar massage is implemented and evaluated.
      • There is a need for further research to substantiate its use in clinical settings.

      Abstract

      Background

      Scar massage is a widely used treatment modality in hand therapy. This intervention is thoroughly discussed in the literature relating to burns rehabilitation, however, the evidence for its use in treating linear scars following surgery is limited.

      Purpose of study

      To collate the empirical literature on scar massage for the treatment of postsurgical cutaneous scars.

      Study Design

      Scoping review.

      Methods

      Medline, EMBASE, CINAHL, AMED, Scopus, ProQuest Dissertations & Theses Global, and the Joanna Briggs Institute were searched from inception to December 2020. Two researchers used a data extraction tool to record key demographic, intervention and outcome data, and to apply the Oxford Levels of Evidence for each study.

      Results

      Twenty-five studies met the inclusion criteria, reporting on a combined sample of 1515 participants. Only two papers addressed hand or wrist scars (92 participants). While all studies reported favorable outcomes for scar massage, there were 45 different outcome measures used and a propensity towards non-standardized assessment. Intervention protocols varied from a single session to three treatments daily for 6 months. The results from 13 studies were confounded by the implementation of additional rehabilitation interventions.

      Conclusions

      The overall findings suggest that while there may be benefits to scar massage in reducing pain, increasing movement and improving scar characteristics; there is a lack of consistent research methods, intervention protocols and outcome measures. This scoping review highlights the heterogenous nature of research into scar massage following surgery and supports the need for further research to substantiate its use in the clinical setting.

      Keywords

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      JHT Read for Credit

      Quiz: # 850

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
      • # 1.
        The study dealt with
        • a.
          any and all scars
        • b.
          bun scars
        • c.
          linear post-surgery scars
        • d.
          Z-plasty post-surgery scars
      • # 2.
        The massage technique was
        • a.
          varied from report to report
        • b.
          uniform for all reported cases
        • c.
          50% myofascial, 50% deep friction
        • d.
          not specified in the study
      • # 3.
        Data was gleaned from
        • a.
          EMBASE
        • b.
          CINAHL
        • c.
          AMED
        • d.
          all of the above
      • # 4.
        Making definitive conclusions was hampered by
        • a.
          too many published studies
        • b.
          poor research methodology
        • c.
          confounding by additional interventions
        • d.
          diverse interpretation of results
      • # 5.
        The literature demonstrated the efficacy of scar massage
        • a.
          true
        • b.
          false
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.