Mechanomodulation: Physical Treatment Modalities Employ Mechanotransduction to Improve Scarring

Abstract

Every year, surgical interventions, traumatic wounds, and burn injuries lead to over 80 million scars. These scars often lead to compromised skin function and can result in devastating disfigurement, permanent functional loss, psychosocial problems, and growth retardation. Today, a wide variety of nonsurgical scar management options exist, with only few of them being substantiated by evidence. The working mechanisms of physical anti-scarring modalities remained unclear for many years. Recent evidence underpinned the important role of mechanical forces in scar remodeling, especially the balance between matrix stiffness and cytoskeleton pre-stress. This perspective article aims to translate research findings at the cellular and molecular levels into working mechanisms of physical anti-scarring interventions. Mechanomodulation of scars applied with the right amplitude, frequency, and duration induces ECM remodeling and restores the ‘tensile’ homeostasis. Depending on the scar characteristics, specific (combinations of) non-invasive physical scar treatments are possible. Future studies should be aimed at investigating the dose-dependent effects of physical scar management to define proper guidelines for these interventions.

Optimization of the cosmetic appearance of skin scar after caesarean section — part II physiotherapy practice

“…The tape applied to skin reduces the tensile forces acting on the scar, reduces the oversensitivity of the skin, and correct the position of the fasciae and skin [46,47]. A new technique for tension-reducing tape was proposed by van Daele et al [48]. The tape is applied around the scar tissue, approximating the scarred skin from the ends towards the middle, horizontally as well as vertically (Fig.…”

New insights into balancing wound healing and scarless skin repair

“…Van Daele et al 123 Cell-free scaffold Recreating a microenvironment similar to a natural ECM accelerates wound healing, reduces scar formation, and promotes tissue regeneration. Effective delivery of drugs or cytokines to improve wound healing.…”

“…The increased mechanical tension acts on the cells at the wound site through various chemical signals. 123 Therefore, it is possible to effectively reduce the production of scar tissue by interfering with these biochemical signals ( Figure 6 ). 124 The technology of limiting fibrosis and reducing scar formation by offsetting the mechanical stress in the wound has been widely used ( Table 2 ).…”