What is the efficacy of Extracorporeal Shock Wave Therapy (ESWT) for treating sternal scar tissue?

From the Guidelines

Extracorporeal Shock Wave Therapy (ESWT) is not recommended for treating sternal scar tissue due to the lack of direct evidence supporting its efficacy for this specific condition. The provided evidence focuses on the effectiveness of interventions for chronic foot ulcers in diabetes, with a section dedicated to shockwave therapy 1. However, this study does not address the treatment of sternal scar tissue.

Key Points to Consider:

• The study identified five trials of shockwave therapy for chronic foot ulcers, but none of these trials addressed sternal scar tissue 1.
• The available evidence on shockwave therapy is limited to its application in chronic foot ulcers, with mixed results regarding its effectiveness 1.
• There is no direct evidence to support the use of ESWT for treating sternal scar tissue, making it difficult to recommend a specific treatment protocol.
• In the absence of direct evidence, it is crucial to prioritize treatments with established efficacy for sternal scar tissue, rather than relying on extrapolations from other conditions.
• Further research is needed to determine the potential benefits and risks of ESWT for sternal scar tissue, as the current evidence base is insufficient to support its use for this indication 1.

From the Research

Efficacy of Extracorporeal Shock Wave Therapy (ESWT) for Treating Sternal Scar Tissue

There are no research papers to assist in answering this question, as the provided studies do not mention Extracorporeal Shock Wave Therapy (ESWT) for treating sternal scar tissue.

Alternative Treatments for Sternal Scar Tissue

• Silicone gel sheets have been shown to be effective in treating keloid scars following median sternotomy 2, 3
• Vacuum-assisted closure therapy has been used to treat sternal wounds and has been shown to decrease the number of dressing changes, reduce the time between débridement and definitive closure, and reduce costs associated with a protracted course of in-hospital dressing changes 4, 5
• Silicone gel sheeting has been compared to other treatments such as pressure garments, silicone gel, topical onion extract, polyurethane, and Kenalog injection, with varying results 6

Limitations of Current Evidence

• The current evidence on the treatment of hypertrophic scars is limited by the small sample sizes and poor reporting of methodology in many studies 6
• Further trials are required to reduce uncertainty around decision-making in the use of various treatments for hypertrophic scars 6