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Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects

Deep dermal defects can result from burns, necrotizing fasciitis and severe soft tissue trauma. Physiological scar restriction during wound healing becomes increasingly relevant in proportion to the affected area. This massively restricts the general mobility of patients. External mechanical influen...

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Detalles Bibliográficos
Autor principal: Koller, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139679/
https://www.ncbi.nlm.nih.gov/pubmed/32192136
http://dx.doi.org/10.3390/ijms21062055
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author Koller, Thomas
author_facet Koller, Thomas
author_sort Koller, Thomas
collection PubMed
description Deep dermal defects can result from burns, necrotizing fasciitis and severe soft tissue trauma. Physiological scar restriction during wound healing becomes increasingly relevant in proportion to the affected area. This massively restricts the general mobility of patients. External mechanical influences (activity or immobilization in everyday life) can lead to the formation of marked scar strands and adhesions. Overloading results in a renewed inflammatory reaction and thus in further restriction. Appropriate mechanical stimuli can have a positive influence on the scar tissue. “Use determines function,” and even minimal external forces are sufficient to cause functional alignment (mechanotransduction). The first and second remarkable increases in connective tissue resistance (R1 and R2) seem to be relevant clinical indications of adequate dosage in the proliferation and remodulation phase, making it possible to counteract potential overdosage in deep dermal defects. The current state of research does not allow a direct transfer to the clinical treatment of large scars. However, the continuous clinical implementation of study results with regard to the mechanosensitivity of isolated fibroblasts, and the constant adaptation of manual techniques, has nevertheless created an evidence-base for manual scar therapy. The manual dosages are adapted to tissue physiology and to respective wound healing phases. Clinical observations show improved mobility of the affected regions and fewer relapses into the inflammatory phase due to mechanical overload.
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spelling pubmed-71396792020-04-10 Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects Koller, Thomas Int J Mol Sci Review Deep dermal defects can result from burns, necrotizing fasciitis and severe soft tissue trauma. Physiological scar restriction during wound healing becomes increasingly relevant in proportion to the affected area. This massively restricts the general mobility of patients. External mechanical influences (activity or immobilization in everyday life) can lead to the formation of marked scar strands and adhesions. Overloading results in a renewed inflammatory reaction and thus in further restriction. Appropriate mechanical stimuli can have a positive influence on the scar tissue. “Use determines function,” and even minimal external forces are sufficient to cause functional alignment (mechanotransduction). The first and second remarkable increases in connective tissue resistance (R1 and R2) seem to be relevant clinical indications of adequate dosage in the proliferation and remodulation phase, making it possible to counteract potential overdosage in deep dermal defects. The current state of research does not allow a direct transfer to the clinical treatment of large scars. However, the continuous clinical implementation of study results with regard to the mechanosensitivity of isolated fibroblasts, and the constant adaptation of manual techniques, has nevertheless created an evidence-base for manual scar therapy. The manual dosages are adapted to tissue physiology and to respective wound healing phases. Clinical observations show improved mobility of the affected regions and fewer relapses into the inflammatory phase due to mechanical overload. MDPI 2020-03-17 /pmc/articles/PMC7139679/ /pubmed/32192136 http://dx.doi.org/10.3390/ijms21062055 Text en © 2020 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Koller, Thomas
Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects
title Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects
title_full Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects
title_fullStr Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects
title_full_unstemmed Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects
title_short Mechanosensitive Aspects of Cell Biology in Manual Scar Therapy for Deep Dermal Defects
title_sort mechanosensitive aspects of cell biology in manual scar therapy for deep dermal defects
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139679/
https://www.ncbi.nlm.nih.gov/pubmed/32192136
http://dx.doi.org/10.3390/ijms21062055
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