Acetic acid iontophoresis for recalcitrant scarring in post-operative hand patients

Agnes Dardas; Gordon H Bae; Arthur Yule; Judith Wright; Noreen Straughn; Charles S Day

doi:10.1016/j.jht.2013.10.008

Acetic acid iontophoresis for recalcitrant scarring in post-operative hand patients

J Hand Ther. 2014 Jan-Mar;27(1):44-8. doi: 10.1016/j.jht.2013.10.008. Epub 2013 Nov 6.

Authors

Agnes Dardas¹, Gordon H Bae², Arthur Yule³, Judith Wright⁴, Noreen Straughn⁴, Charles S Day⁵

Affiliations

¹ Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA.
² Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA; Harvard College, Cambridge, MA, USA.
³ Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA; Harvard College, Cambridge, MA, USA.
⁴ Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA.
⁵ Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA. Electronic address: cday1@bidmc.harvard.edu.

PMID: 24373451
DOI: 10.1016/j.jht.2013.10.008

Abstract

Study design: Retrospective cohort comparison.

Introduction: Using acetic acid iontophoresis (AAI) as a treatment modality significantly improved the functionality of hand in patients with recalcitrant scarring.

Methods: Open trigger finger release patients followed up exclusively at a hand clinic between 2009 and 2011 were analyzed. Group I recovered optimal total active range of motion (TAM) after 14 standard of care (SOC) therapy sessions but Group II (10 digits) could only reach optimal recovery after 7 additional AAI sessions.

Results: After SOC therapy, Group I's TAM recovery plateaued at 245 and Group II's at 219 (p < 0.01). After undergoing AAI, the TAM of Group II increased from 219 to 239 (p < 0.01).

Discussion: Clinical studies suggest that AAI can modify collagen structure in scars. AAI could be a novel non-surgical treatment for restoring functionality to areas affected by difficult, recalcitrant scars.

Conclusion: AAI significantly improved the TAM of hand surgical patients who could not recover optimally with SOC therapy alone.

Level of evidence: Level 3.

Keywords: Acetic acid; Lontophoresis; Scar therapy; Total active range of motion; Trigger finger.

Publication types

Comparative Study

MeSH terms

Acetic Acid / administration & dosage*
Aged
Cicatrix / prevention & control*
Cohort Studies
Combined Modality Therapy
Female
Humans
Iontophoresis*
Male
Middle Aged
Occupational Therapy
Physical Therapy Modalities
Postoperative Care
Postoperative Complications / prevention & control*
Retrospective Studies
Trigger Finger Disorder / surgery*

Substances

Acetic Acid