Open Access Article: Post-surgical scar assessment in rehabilitation: a systematic review

This is an open access article

Manual therapies are frequently recommended to improve post-surgical scar pliability, e.g., its elasticity and glide capacity with respect to the underlying tissue. A significant percentage of scars are pathological, causing pain, functional/psychological disorders, or cosmetic damage. Hence, early identification of a pathological post-surgical scar is crucial for prompt treatment so as to optimize and evaluate outcome. Scar assessment tools provide data on objective parameters as the basis for planning treatment.

While the published literature contains many reviews on validated tools for post-surgical scar assessment, none specifically analyzes tools for use in the rehabilitative setting. The aim of this focused review was thus to illustrate the tools-instruments, scales and questionnaires-validated to assess post-surgical scar pliability in rehabilitation.

A literature search was conducted on articles published in journals indexed by PubMed before October 15, 2014. The literature search produced 72 papers, 6 of which met our inclusion criteria. These 6 articles deal with the validation of 5 different tools to assess post-surgical scar. Three are devices aimed to assess different pliability characteristics: Adheremeter (degree of scar adherence), Cutometer (elasticity), and Tissue Ultrasound Palpation System (scar thickness). The other two are rating scales developed for general scar assessment (Vancouver Scar Scale, and Patient and Observer Scar Assessment Scale). As the efficacy of manual therapy on post-surgical scar is still debated, it is desirable that in the future increasing use be made of validated tools as outcome measures of the rehabilitation treatment.