Tension offloading improves cutaneous scar formation in Achilles tendon repair

Abstract

Hypertrophic scar formation and non-healing wounds following Achilles tendon repair arise from poor vascularity to the incisional site or from excess mechanical stress/strain to the incision during the healing process. The embrace® scar therapy dressing is a tension offloading device for incisional scars. This study explored the effects of tension offloading during Achilles scar formation. A healthy 30-year-old male without any medical co-morbidities developed an acute rupture of his left Achilles tendon. The patient underwent open repair 1 week after injury. At post-operative day (POD) 14, the patient started daily tension offloading treatment on the inferior portion of the incision through POD 120. By POD 120, the untreated portion of the Achilles incision appeared hypertrophic and hyperpigmented, while the treated portion of the scar appeared flat with minimal pigmentation changes. The 12-week treatment of tension offloading on an Achilles tendon repair incision significantly improved cosmesis compared to untreated incision.

Clinical Observation of Sequential Laser Therapy Combined with Tension Reducer for Postoperative Tension Incision Scar Growth

“…A related study using CO 2 fractional laser to control scar growth after skin cancer surgery found that the CO 2 fractional laser was effective in controlling scar thickness and flexibility. 15 Furthermore, studies have shown that the use of tension-reducing devices such as tension-reducing tape 16 and tension reducers 17 , 18 are also clinically effective in inhibiting postoperative scar growth. These devices not only reduce the thickness of the scar, but also the width of the scar.…”

Effectiveness of fractional carbon dioxide laser combined with botulinum toxin type A in a rabbit ear model with the underlying mechanism

“…Tension is one of the major causes of HS formation, and persistent tension in the lesion is more likely to cause HS formation. 25 The most common clinical locations for HS are in the chest, back, and joint motion areas with high tension. Because of persistent tension, HSs in these areas are more likely to recur after treatment.…”