The effect of scar tissue massage on pain, tactile sensation, tissue healing, scar quality and functional status after cesarean section

This study was planned to investigate the effect of scar massage on cesarean section scar tissue on pain, tactile sensation, tissue healing, scar quality, and functional status. The study included 20 women between the ages of 18 and 35, who had a single or first cesarean birth at 34 weeks and were in the 6th week after cesarean section. The women were randomly divided into two groups, and the first group was the training group (n:10), which was taught scar massage by a physiotherapist with daily life activity recommendations and followed by video, and the second group was the control group, which was not receive scar massage treatment but only made daily life activity recommendations (n:10). The training group performed self-scar massage 3 times a week, for 20 minutes a day, for 6 weeks and was followed up with video calls. Scar quality; Patient and Observer Scar Assessment Scale (POSAS), pain assessment; digital pressure algometer and Leeds Neuropathic Sign and Symptom Assessment (LANSS), sensory assessment; Semmes-Weinstein monofilament and two-point discrimination (TPD) test, functionality; Oswestry Disability Index (ODI) and thermographic values were evaluated using a thermal camera. As a result of our study, in the scar massage training group; POSAS (p=0, 005), LANSS (p=0, 005), ODI score (p=0, 005), monofilament values (p=0, 005) and scar area TPD value (p=0, 005) decreased statistically significantly, while the pressure threshold value (p=0,005) increased significantly. In the control group, there was a statistically significant decrease in POSAS (p=0,007), ODI score (p=0,005), monofilament scar area value (p=0,005), and temperature difference (p=0,005). When the last measurements of the groups were compared, while the POSAS (p=0,001), LANSS (p=0,01) and ODI scores (p=0,009) of the scar massage training group were statistically significantly lower, the pressure pain threshold value (p=0,001) was significantly higher than the control group. When comparing the difference values of the groups; POSAS (p=0,002), LANSS (p=0,0000), ODI score (p=0,003), pressure threshold value (p=0,000), temperature difference (p=0,000), scar area TPD value (p=0,001) were statistically significantly different in favor of the training group. In conclusion, scar massage provided improvement in scar quality, tactile sensation, tissue healing, and functional status parameters and decreased pain in women who underwent cesarean section surgery. Based on these results, cesarean scar massage which the patients apply under the observation of a physiotherapist is an effective, safe, and cheap alternative treatment method. Keywords: Scar, Manual therapy, Postoperative pain, Telerehabilitation, Thermal camera