Gen Ortho- Scars

taylormaloney's version from 2016-10-04 04:19

Section 1

Question Answer
Define Scar TissueA collagen based tissue that develops as a result of the inflammatory process.
Scar Tissue is necessary for the healing of what types of damaged tissues?Skin, muscle, tendon, ligament,and fascia.
Depending on the amount of tissue loss the body will heal via what two methods?First and second intention.
When does the tissue formally become 'scar tissue'?When the collagen fibres mature.
Is the scar stronger or weaker than the tissue it replaces?Weaker, only reaching approx 80% of original strength.
What are the three general causes of scar tissue?A result of inflammation, prolonged immobilization, and paralysis/paresis.

Section 2

Question Answer
What are the different types of scar tissue?Contracture, Adhesion, Scar Tissue Adhesion, Fibrotic Adhesion,Irreversible Contracture, Proud Flesh, Hypertrophic, and Keloid.
Define ContractureShortening of CT supporting structures on/around a joint. Cannot fully lengthen- reduced ROM at a joint. Can include adhesions/irreversible contractures.
Define AdhesionOccurs when reduced motion at a joint allows cross links to form among collagen fibres. Reducing ROM. Most evident as seen in postural dysfunction/immobilization of limb.
Define Scar Tissue AdhesionOccurs with injury/acute inflammation. Collagen fibre formation during tissue repair causes contractures + adhesions. Between skin, muscle, tendons and groups of muscles. Can occur in joint capsule.
Define Fibrotic AdhesionOccurring with ongoing chronic inflammation- moderate to severe restrictions that are difficult to resolve.
Define Irreversible ContractureWhen fibrotic tissue or bone replaces muscle/CT. Permanent loss of ROM, only resolved through surgery.
Define Proud FleshThick dermal granulation tissue that results from abnormal healing.Wound does not re-epithelialize- causing chronic inflammation.Resulting tissue formed by disorganized collagen and capillaries.Raised/red structure, can be surgically cut back.
Define Hypertrophic ScarringAn overgrowth of dermal tissue that remains within the boundaries of original wound.Collagen fibres formed in random nodular/whirl patterns.May occur at site of severe burns, skin grafts, skin graft donor sites. May be surgically excised and resutured.
Define KeloidDermal scar tissue that extends beyond borders of original wound. Tumor-like growth, More random than hypertrophic, may continue to grow for several years. Do not respond well the surgical excision, Steroids used to reduce/prevent keloids.

Section 3

Question Answer
Are keloids more prominent in a specific group of people?Yes, darker skin tones such as AfricanAmerican/Asian ancestry.
Is there a specific age that produces more scar tissue?Younger people tend to produce more, due to the overall higher rate of collagen production.
Are there certain areas of the body that are more prone to produce scar tissue?Hypertrophic- more likely on sternum, upper back/shoulders, deltoid region, dorsum of foot. Keloids- more likely between ear level to waist level + shoulder to elbow.
Keloids are considered to be ...Benign Tumors.
What type of scar is more common, not as big, will fade with time and effects all racial groups?Hypertrophic Scars.
What type of wound is likely to produce an excess of scar tissue?A deep burn, due to excessive edema and granulation tissue.

Section 4

Question Answer
Massage therapy goal before scar tissue develops?Decrease edema, less edema= less scar tissue.
By freeing restrictive fibrous bands and increasing circulation, massage therapy can help to...?Soften scar tissue- blanching followed by hyperemia with stretching of tissues after treatment.
How can massage therapy benefit hypersensitive scars?By using tactile stimulation massage therapy can help desensitize these areas.
Massage applied before the collagen matures can prevent..Hypertrophic scarring- especially in burns.
What are the general CI's in regards to scar tissue?No frictions if pt has taken anti-inflammatories, no frictions on proud flesh or keloid scars.