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Review
. 2023 Apr 19;24(8):7487.
doi: 10.3390/ijms24087487.

The Role of Physical Therapies in Wound Healing and Assisted Scarring

Montserrat Fernández-Guarino  1 , Stefano Bacci  2 , Luis Alfonso Pérez González  1 , Mariano Bermejo-Martínez  3 , Almudena Cecilia-Matilla  4 , Maria Luisa Hernández-Bule  5
Affiliations
Review

The Role of Physical Therapies in Wound Healing and Assisted Scarring

Montserrat Fernández-Guarino et al. Int J Mol Sci. .

Abstract

Wound healing (WH) is a complex multistep process in which a failure could lead to a chronic wound (CW). CW is a major health problem and includes leg venous ulcers, diabetic foot ulcers, and pressure ulcers. CW is difficult to treat and affects vulnerable and pluripathological patients. On the other hand, excessive scarring leads to keloids and hypertrophic scars causing disfiguration and sometimes itchiness and pain. Treatment of WH includes the cleaning and careful handling of injured tissue, early treatment and prevention of infection, and promotion of healing. Treatment of underlying conditions and the use of special dressings promote healing. The patient at risk and risk areas should avoid injury as much as possible. This review aims to summarize the role of physical therapies as complementary treatments in WH and scarring. The article proposes a translational view, opening the opportunity to develop these therapies in an optimal way in clinical management, as many of them are emerging. The role of laser, photobiomodulation, photodynamic therapy, electrical stimulation, ultrasound therapy, and others are highlighted in a practical and comprehensive approach.

Keywords: chronic wound; electromagnetic fields; hypertrophic scar; keloid; laser; photobiomodulation; photodynamic therapy; physical therapies; radiofrequency; ultrasound therapy; wound healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scheme of the stages of wound healing. IL1: interkeukin1; TNF: Tumor necrosis factor; ROS: single oxygen radicals; TGF: transforming growth factor; VEGF: vascular endothelial growth factor; MMP: metalloproteinases.
Figure 2
Figure 2
Diagram representing different targets with physical therapies (PT) for promoting wound healing (WH). PBM: photobiomodulation; LFU: low frequent ultrasound; PDT: photodynamic therapy; ES: electrostimulation; VPL: visible pulsed light; PEMF: pulsed electromagnetic fields; BT: biophotonic therapy; RF: radiofrequency.
Figure 3
Figure 3
Scheme of strategies for physical therapies (PT) in assisted well-scaring.
Figure 4
Figure 4
Diagram of the relationship between visible light (blue, red) and near-infrared (NIR), penetration and chromophores.
See this image and copyright information in PMC

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