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Three Part Question

In [Adults with hypersensitive scars after routine surgery] is [electrotherapy better than any manual therapy] at [desensitising the scar]

Clinical Scenario

A 50 years old lady is 3 months post surgery to the wrist for Carpal Tunnel Syndrome. Although her previous symptoms related to CTS have resolved and her wound is well healed, her recovery has been hindered by a hypersensitive surgical scar. Consequently, she is referred to physiotherapy to help resolve these symptoms where there are mixed views about whether electrotherapy or a more manual form of therapy is the best technique for desensitising the scar.

Search Strategy

Medline, 1966-08/05, CINAHL 1982 –08/05, AMED 1985-08/05, EMBASE 1996-08/05:
[{(exp scar OR scarring.mp OR cicatrix.mp OR hypersens$.mp) AND [(exp physiotherapy OR physical therapy.mp OR exp ultrasound therapy OR electrotherapy.mp OR exp massage OR desensitis$.mp)] LIMIT to human AND English language.
In addition the Cochrane database and PEDro database were also searched with search terms: [desensitisation OR scarring OR scars]

Search Outcome

32 papers were retrieved, none of which were relevant to the 3 part question.

Comment(s)

These papers studied treatment of hypertrophic scars, ulcerations, burn-scars, thermal injury or used outcome measures such as joint motion and skin mobility but not hypersensitivity. Only one paper referred to hypersensitivity. This was a descriptive text on the authors' experiences of using Opsite Flexifix® as part of a therapy programme for 42 patients with various diagnoses. There was 1 RCT of physio versus ultrasound & physio, but was on patients with extremities injured by burns, not post operative scarring

Clinical Bottom Line

There is no evidence base at present on the most efficacious treatment for hypersensitive scars post routine surgery.