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Restoring function and confidence
To improve access to timely and high quality early scar management , Joep Fernando has co-founded a private practice . Here he looks at this important and emerging role for occupational therapists .
© PeopleImagesvia Getty Images
A pproximately 100 million new scars are formed every year in the developed world following surgery alone ( Brown et al 2008 ) and high quality scar management should be an accessible , routine pathway to mitigate the risk of the devastating lifelong impact of scarring ( Obi 2022 ).
With clinicians having limited knowledge and experience in scar management ( Dastagir et al 2021 ) patients are often left living with symptomatic scars ( itching , pain , discomfort and restricted range of movement ), which limits occupational performance in self-care , leisure and productivity domains .
There is a general academic consensus that early scar management reduces risks of excessive scarring ( De Decker et al 2022 ; Kim et al 2022 ; Yuan et al 2023 ), although high quality evidence is scarce .
As an occupational therapist , I assess and provide conservative non-invasive recommendations for full body excessive or problematic scarring ( excluding acute burns ), such as hypertrophic scars and keloid scars . Scar therapy can include :
• silicone therapy
• compression therapy
• ScarWork massage
• exercises and advice
• kinesiology taping
• instrument assisted soft tissue massage
• skin camouflage ( paramedical makeup ).
Why occupational therapy ?
Occupational therapists are well suited to provide scar management , due to our ability to use a biopsychosocial approach , taking into account the emotional , physical and social factors that may influence a person ’ s occupational performance .
Activity analysis is another key role of occupational therapy , which helps to break down a task into specific components and identify any barriers to participation .
Scar therapy is theorised to follow the biomechanical frame of reference . According to Brown et al ( 2008 ) there are five key domains to scar management :
• physical comfort ( scar maturation interventions )
• function ( improving occupational performance )
• social integration ( adaptation , activity modification )
• trust in the healing process ( knowledgeable therapists who have established therapeutic rapport )
46 OTnews February 2024