Hand surgeons carefully plan their incisions for surgery and recommend therapy protocols following surgical interventions to prevent abundant scar formation. While some scarring is a necessity for closure of a surgical wound, too much scarring or thick, hypertrophic scarring may cause loss of motion and sensitivity.
For example, a trigger finger release procedure allows the tendon to glide more easily through the A1 pulley area, however adherent scarring at this surgical site can impede the glide of the flexor tendon. Specific to the dorsal hand, the normal skin redundancy typically allows finger and wrist mobility, but adherent scarring in this area can limit the stretch of the soft tissue needed for wrist and digit flexion or can limit the glide of the tendons through the dorsal hand for digit extension. Because the hand is small and complex with many structures, the complications from scarring can be detrimental to outcomes. Therefore, it is important to care for scars following hand surgery.
Scar massage is likely the most implemented treatment intervention used in caring for scars on the hand, outside of active range of motion exercises (which are important for gliding soft tissue). The theory behind scar massage effectiveness is that it increases blood flow which is important to cellular level healing and provides important sensory input to scarring that assists with decreasing the sensitivity of the healing skin. In addition, the pressure on the contracting collagen fibers that compose scar tissue assists with remodeling, allowing a more supple scar. Review of scientific literature reveals support for the use of scar massage in a therapeutic program to address range of motion deficits in the vicinity of hand joints.
Scar massage is typically initiated following suture or staple removal depending on the integrity of the skin. The scar is massaged in a circular motion or across the scar a few times a day for 5-10 minutes. Scar massage can be performed by hand or with the help of a tool or vibrating massager with a comfortable pressure, but greater force with more mature scar.