Rehabilitation of athletes after caesarean section with pathological scarring

Aim. This paper aims to develop a rehabilitation program for postoperative pathological and functionally significant scars and to evaluate its clinical efficacy. Materials and methods. The study involved 65 female athletes (mean age 20.6 ± 2.9 years) after caesarean section with pathological scarring. The study centers included the Kinzerskiy medical center, the Center for Neuromuscular Stabilization, the Department of Sports Medicine and Physical Rehabilitation, and the Scientific and Research Institute of Olympic Sports (Ural State University of Physical Education). The content of lipid oxidation products and Fe2+/ascorbate-induced peroxidation were studied by the spectrophotometric method. Patients were divided into three groups: Group A - botulinum toxin type A (BTA) therapy. BTA reconstituted with 0.9 % saline at a standard concentration was injected directly into a scar (2 units per 1 sq cm of the scar). Group B received manual therapy and kinesiotaping. Group C received manual therapy, kinesiotaping, and BTA therapy simultaneously. The control group of healthy volunteers was of the same age and sex. Results. The results obtained demonstrate a decrease in clinical signs and symptoms and a significant cosmetic effect. In patients with functionally significant postoperative scars, activation of lipid peroxidation was recorded against decreased antioxidant activity in the blood serum. The most significant improvement was achieved with combined manual therapy, kinesiotaping, and BTA. Conclusion. Rehabilitation of functionally significant scars should be comprehensive and include several techniques. The use of botulinum toxin type A in a complex therapy contributes to the successful treatment of clinically significant hypertrophic scars, where stimulation of plastic and trophic processes in tissues is necessary.