Scar management. Patient Information Service. Southend University Hospital NHS Foundation Trust. Rehabilitation department Hand therapy

Transcription

1 Southend University Hospital NHS Foundation Trust Patient Information Service Rehabilitation department Hand therapy Scar management SOU4375_078504_0418_V1.indd 1 13/04/ :14

2 Scar tissue performs the vital job of mending the body. Scars are commonly caused by injury, surgery and burns. All scars are red at first and may be raised or itchy. They mature over a period of months becoming paler and flatter, sometimes this process can take up to two years. Massage helps by: Encouraging collagen to line-up to form a more pliable scar rather than a restrictive and tight scar Flushing cell debris out of the area and improves circulation Making the scar less sensitive Reduce dryness or itching Preventing scar adhesions as all the injured layers of skin, muscle, tendon and other structures can scar and stick together Help increase movement. Manual scar massage After two weeks or so when the scar has formed and the skin healed, wash and dry the scar, then apply an unscented cream or lotion, eg E45 or aqueous cream to the scar. Using the thumb or the middle finger of your other hand, massage in a slow circular motion using moderately firm pressure. The scar will feel softer and pliable after the massage. Massage the scar times a day for five minutes. 1 SOU4375_078504_0418_V1.indd 1 13/04/ :14

3 Desensitisation Desensitisation is used to treat skin hypersensitivity. What is hypersensitivity? Hypersensitivity is an exaggerated pain/sensation to a normally non-painful stimulus. It can occur in skin after an injury or surgery that produces scar tissue and/or nerve damage. Symptoms may take the form of intense burning, stinging and shooting pains, irritability and tingling. What is desensitisation? Desensitisation is a controlled, graded technique aimed at reducing these symptoms. The result should be an increase in the ability to tolerate normal touch to the affected area. To begin desensitisation it is recommended that you carry out the following steps up to four times a day, each treatment session should last approximately five to ten minutes. You should experience discomfort but stop if it becomes unbearable. Graded textures are used to stroke the hypersensitive area. The following is a suggested list of progression; cotton wool jumper/clothing felt towel Velcro loops. SOU4375_078504_0418_V1.indd 2 13/04/ :14

4 Do not advance to a more irritating stimulus until the ones you are using have become comfortable. The same method of desensitisation can be used by immersing the hand into containers of various particles for up to 30 seconds at a time. sand beans popcorn cotton wool rice pasta. Progression should only be attempted when the less irritating particles can be tolerated. Other treatments for hypersensitivity include massage, vibration, compression gloves and TENS (If indicated this treatment will be discussed with you by your therapist). Your progress will be monitored by your therapist and any problems should be reported. Silicone Silicone is a gel-like substance that comes in a sheet or a tube and has been shown to be effective in treating scarring and has been recommended as first line treatment of hypertrophic or keloid scars. Silicone can help flatten soften and smooth scars, relieve discomfort and discolouration. 3 SOU4375_078504_0418_V1.indd 3 13/04/ :14

5 Before application, ensure skin is clean. Do not apply creams, lotions, powders, ointment or perfumes to the area Cut a piece of gel long/wide enough to cover the scar, remove protective film and place sticky side directly onto the scar. Alternatively you will have a piece of silicone polymer moulded to fit your scar Hold the gel in place with hypoallergenic tape, (eg micropore), tubigrip or your splint (if you have one) When first using the silicone, wear for only two hours. Slowly build the duration of use each day until eight hours minimum to 12 hours maximum are reached Check your skin regularly to ensure you are not developing a reaction. Should a rash or itching occur, remove the silicone for 48 hours then try using it again. If the reaction persists please discontinue use and contact the hand therapy department If no reaction occurs, wear the gel at night OR during the day for a minimum of eight hours and a maximum of 12 hours out of every 24 hours To prolong the life of the silicone wash daily with warm MILD soapy water, rinsing completely and patting dry. Keep covered in the fridge when not being worn. This prevents it from drying out If you are using silicone gel it may begin to perish (becomes white, opaque and crumbles). If this occurs you should replace it with another piece 4 SOU4375_078504_0418_V1.indd 4 13/04/ :14

6 Continue use of gel for four to six months If you run out of gel and are no longer attending the therapy department, your local pharmacy should be able to order some for you. Alternatively discuss it with your GP who MAY issue a prescription. 5 SOU4375_078504_0418_V1.indd 5 13/04/ :14

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8 Southend University Hospital NHS Foundation Trust Patient Information Service If this leaflet does not answer all of your questions, or if you have any other concerns please contact the hand therapy team on: ext For a translated, large print or audio tape version of this document please contact: Patient Advice & Liaison Service (PALS) Southend University Hospital NHS Foundation Trust Prittlewell Chase Westcliff-on-Sea Essex, SS0 0RY Telephone: Fax: pals@southend.nhs.uk Written by the hand therapy team Reviewed and revised April 2018 Leaflet due for revision April 2020 Form No. SOU4375 Version 2 SOU4375_078504_0418_V1.indd 7 13/04/ :14