Vacuum Massage in the Treatment of Scars

AbstractVacuum massage is a noninvasive mechanical massage technique performed with a mechanical device that lifts the skin by means of suction to create and mobilize a skin fold. It was invented by a French engineer suffering from burn scars after a car accident and has since then been frequently used for the treatment of burn scars.The two most reported physical effects of vacuum massage were improvement of the tissue hardness and the elasticity of the skin. Besides physical effects, a variety of physiological effects are reported in the literature, for example, an increased number of fibroblasts and collagen fibers accompanied by an alteration of fibroblast phenotype and collagen orientation. Little information was found on the decrease of pain and itch due to vacuum massage.Although vacuum massage initially had been developed for the treatment of burn scars, a literature review found little evidence for the efficacy of this treatment. Variations in duration, amplitude, or frequency of the treatment have a substantial influence on collagen restructuring and reorientation, thus implying possible beneficial influences on the healing potential by mechanotransduction pathways. Vacuum massage may release the mechanical tension associated with scar retraction and thus induce apoptosis of myofibroblasts. Suggestions for future research include upscaling the study design, investigating the molecular pathways and dose dependency, comparing effects in different stages of repair, including evolutive parameters and the use of more objective assessment tools.