Hello, my name is Ruva and I am a hand occupational therapy student
in the Pulvertaft Hand Centre at the Royal Derby Hospital.
Today I will briefly be speaking about scar management
and I will also demonstrate some of the treatment options your therapist may discuss with you.
I will be demonstrating how to manage scar sensitivity, scar massage and the use of silicone
gel.
What is a scar?
A scar is a mark left on the skin after a wound or injury has healed.
Scars are a natural part of the healing process. Most will fade and become paler over time,
although they may never completely disappear.
Normal scar healing process often takes approximately 12-18 months.
Scarring is part of the body's natural healing response to injury or surgery.
Scar tissue however,
will not be the same as normal tissue; it is rigid and less stretchy.
Scarring can affect you both physically and psychologically.
The ideal scar:
The scar tissue should not be hard and the scar should settle to a pale,
scar that can move easily without limiting any movement.
Abnormal scarring.
Such as Hypertrophic Scars.
Which are red and raised to start with,
before becoming flatter and paler over the course of several years.
Keloid scars which are red,
raised above the skin and are purple when newly formed,
before gradually becoming paler.
They're often itchy or painful,
and can restrict movement if they're tight and near a joint.
These types of scars occur when there is a problem in the wound healing process
which results in scars that may be:
Thick.
Tethered.
Sensitive to touch and temperature.
Itchy.
Painful.
Raised.
Tight.
Lumpy.
I will now demonstrate a few scar management techniques.
Firstly we will look at how to manage scar sensitivity.
Using texture massage,
play around with the textures that cause you the least discomfort
to the most discomfort using a good amount of pressure.
Immersion massage,
fill a container with different particles of different textures,
smooth and rough, using rice, lentils or pasta.
Function, it is important to begin using your hand normal everyday tasks activities such
as:
washing dishes, playing cards and writing.
I will now demonstrate how to massage your scar with some Lotion and Dycem Matin.
You will need to ensure that your scar is sealed,
healed and dry before you start your massage.
The sooner you begin scar massage,
the better as it prevents the scar from becoming tethered to the soft tissue under the skin.
Massage usually for 5-10 minutes or until the area is numb.
The ideal technique should be small circular motions,
up and down the length of the scar and side to side.
Massage will reduce swelling and scar sensitivity.
It can be used throughout the stages of healing.
You can use aqueous based creams which will moisturise your scar and help to protect against
any blistering,
itching and dryness along with softening the scar tissue.
Your therapist may provide you with some dycem matin with the aim of adding friction when
completing your scar massage.
I will now demonstrate how your therapist may use silicone gel for your scar.
Your therapist may give you some silicone gel which aims to flatten,
soften, reduce redness and improve texture of the scar.
Its benefits include: an increase in skin temperature,
enhancing healthy healing process.
Your therapist will give you an information sheet on silicone gel,
which will provide you with information on when the gel should be worn,
how you should care for the gel and possible side effects.
There are other treatment options that your therapist may provide for you such as:
Skin Camouflage To help with the appearance of your scar.
Pressure garments which aim to relive itching,
pain, hypersensitivity, swelling and provide a protective shield to delicate scar tissue.
Suction which aims to lift the scar tissues above and below the skin,
essentially pulling them apart so that fresh blood can circulate freely through them.
Ultrasound which may be used by your therapist to speed up the healing process by putting
energy into the scar area.
Coban which will provide pressure to scar and also help with the swelling.
Your therapist will also discuss any precautions with you.
I hope you have found this video useful.
Thank you for watching this video.