Various treatment methods are used to support regeneration during the skin’s scar formation process following accidents, illnesses, or surgical procedures, and to improve scar quality. Scar treatment measures are made more effective through the use of various aids, and self-management of scar treatment is becoming increasingly important. This study uses various standardized questionnaires to investigate whether the targeted application of SISSEL® EPIFLOW Kinesiology Tape can positively influence the experience of pain and tension, the quality of scar tissue, and the individual’s perceived quality of life.
The study was designed as a prospective longitudinal study with a pre-post design over a period of 3 weeks (n=26). The participants underwent a 3-week intervention with the product, which consisted of a previously instructed, self-administered home-use program on 5 consecutive days per week, 3 times daily, followed by a 2-day break. At both assessment time points, the quality and intensity of individual perceptions of pain and tension, the assessment of scar quality (self-assessment and external assessment), and individual well-being were measured using specific questionnaires.
Following the 3-week home-based intervention, the participants showed significant improvements in their subjective perceptions of pain and tension,
in their individual quality of life, and in their self-assessments of the overall appearance and feel of their scars. Observer assessments of various scar characteristics also showed significant improvement.
The survey results confirm previous findings that the targeted use of SISSEL® EPIFLOW Kinesiology Tape has a positive effect on pain and tension, scar quality, and individual quality of life in patients who have undergone cesarean sections. The use of SISSEL® EPIFLOW Kinesiology Tape enables simple, enhanced self-management in the care of linear surgical scars. To generalize these findings, controlled-group studies, an increase in the number of participants, and further investigations with specific target and user groups are necessary.
Cesarean section, pain, scar quality, quality of life, well-being, self-management
Various treatment methods are used to support regeneration during the skin’s scar formation process following accidents, illnesses, or surgical procedures, and to improve scar quality. Scar treatment measures are made more effective through the use of various aids, and self-management of scar treatment is becoming increasingly important. This study uses various standardized questionnaires to investigate whether the targeted application of SISSEL® EPIFLOW Kinesiology Tape can positively influence the experience of pain and tension, the quality of scar tissue, and the individual’s perceived quality of life.
The study was designed as a prospective longitudinal study with a pre-post design over a period of 3 weeks (n=26). The participants underwent a 3-week intervention with the product, which consisted of a previously instructed, self-administered home-use program on 5 consecutive days per week, 3 times daily, followed by a 2-day break. At both assessment time points, the quality and intensity of individual perceptions of pain and tension, the assessment of scar quality (self-assessment and external assessment), and individual well-being were measured using specific questionnaires.
Following the 3-week home-based intervention, the participants showed significant improvements in their subjective perceptions of pain and tension,
in their individual quality of life, and in their self-assessments of the overall appearance and feel of their scars. Observer assessments of various scar characteristics also showed significant improvement.
The survey results confirm previous findings that the targeted use of SISSEL® EPIFLOW Kinesiology Tape has a positive effect on pain and tension, scar quality, and individual quality of life in patients who have undergone cesarean sections. The use of SISSEL® EPIFLOW Kinesiology Tape enables simple, enhanced self-management in the care of linear surgical scars. To generalize these findings, controlled-group studies, an increase in the number of participants, and further investigations with specific target and user groups are necessary.
Cesarean section, pain, scar quality, quality of life, well-being, self-management
Scarring is a natural part of the skin’s regeneration following accidents, illnesses, or surgical procedures. The severity of the injury, the Size of the wound, and its location on the body result in different types of scars during the healing process, with factors such as age, ethnicity, and genetics further influencing scar formation and its outcome. Because scars are connected to deeper structures, they can affect the muscular and
fascial systems, which may lead to various functional complaints (1). To improve the scar formation process, there are a variety of treatment options that can help enhance the appearance of scars and reduce the discomfort associated with them. A well-known form of scar treatment is scar massage, which—depending on the degree of wound healing, sensitivity, tissue condition, metabolic status, etc.—can range from the lightest touch to intensive mobilization involving friction and traction on the tissue (2). Scar massage focuses on mechanical, biochemical, and reflexive effects that have a positive impact on swelling, pain, tissue tone, and metabolic status in the scarred area, thereby improving the functionality of the scar tissue (1). Scar treatment measures are supported and made more effective through the use of various aids, such as scar pens, scar tapes, scar rollers, or brushes. Self-management of postoperative scar treatment by the patient is becoming increasingly important for promoting the healing process and functional recovery beyond physical therapy care and ensuring these outcomes in the long term. Thanks to its targeted design, the SISSEL® EPIFLOW Kinesiology Tape optimally complements and expands treatment options for scar management in physical therapy and supports self-care. In combination with a specialized application program, patients can be supported in the self-management of their scar-related symptoms. The results of this study aim to objectively assess previous experiences with the SISSEL® EPIFLOW Kinesiology Tape and the benefits o for s for women following cesarean section.
This study aims to examine for women who have undergone cesarean section and are experiencing resulting pain and paresthesia, to determine whether the targeted application of SISSEL® EPIFLOW Kinesiology Tape as part of scar care can improve these symptoms and alter the experience of pain and tension. Furthermore, the study aims to determine whether the application of SISSEL® EPIFLOW Kinesiology Tape in the study participants can lead to an improvement in the condition of the scar tissue
—such as adhesions or scar tissue growth—as well as to an improvement in their individually perceived quality of life. The specific research questions are: What effects can be achieved in patients after a cesarean section through a 3-week SISSEL® EPIFLOW Kinesiology Tape intervention—as self-treatment following instruction—as part of scar care, on individual perceptions of pain and tension in the scar area, on the visual, tactile, and sensory experience of the cesarean scar, as well as on their individually perceived quality of life?
Scarring is a natural part of the skin’s regeneration following accidents, illnesses, or surgical procedures. The severity of the injury, the Size of the wound, and its location on the body result in different types of scars during the healing process, with factors such as age, ethnicity, and genetics further influencing scar formation and its outcome. Because scars are connected to deeper structures, they can affect the muscular and
fascial systems, which may lead to various functional complaints (1). To improve the scar formation process, there are a variety of treatment options that can help enhance the appearance of scars and reduce the discomfort associated with them. A well-known form of scar treatment is scar massage, which—depending on the degree of wound healing, sensitivity, tissue condition, metabolic status, etc.—can range from the lightest touch to intensive mobilization involving friction and traction on the tissue (2). Scar massage focuses on mechanical, biochemical, and reflexive effects that have a positive impact on swelling, pain, tissue tone, and metabolic status in the scarred area, thereby improving the functionality of the scar tissue (1). Scar treatment measures are supported and made more effective through the use of various aids, such as scar pens, scar tapes, scar rollers, or brushes. Self-management of postoperative scar treatment by the patient is becoming increasingly important for promoting the healing process and functional recovery beyond physical therapy care and ensuring these outcomes in the long term. Thanks to its targeted design, the SISSEL® EPIFLOW Kinesiology Tape optimally complements and expands treatment options for scar management in physical therapy and supports self-care. In combination with a specialized application program, patients can be supported in the self-management of their scar-related symptoms. The results of this study aim to objectively assess previous experiences with the SISSEL® EPIFLOW Kinesiology Tape and the benefits o for s for women following cesarean section.
This study aims to examine for women who have undergone cesarean section and are experiencing resulting pain and paresthesia, to determine whether the targeted application of SISSEL® EPIFLOW Kinesiology Tape as part of scar care can improve these symptoms and alter the experience of pain and tension. Furthermore, the study aims to determine whether the application of SISSEL® EPIFLOW Kinesiology Tape in the study participants can lead to an improvement in the condition of the scar tissue
—such as adhesions or scar tissue growth—as well as to an improvement in their individually perceived quality of life. The specific research questions are: What effects can be achieved in patients after a cesarean section through a 3-week SISSEL® EPIFLOW Kinesiology Tape intervention—as self-treatment following instruction—as part of scar care, on individual perceptions of pain and tension in the scar area, on the visual, tactile, and sensory experience of the cesarean scar, as well as on their individually perceived quality of life?
The study was designed as a prospective longitudinal study with a pre-post design. The study protocol is illustrated in Fig. 1. IBM SPSS Statistics 29 software was used to analyze the collected data. The data were tested for normal distribution (Shapiro-Wilk test), and in addition to descriptive statistics, t-tests for paired samples were performed. The significance level was set at 5%. The female participants were recruited from the patient populations of various physical therapy practices through direct outreach, local posters, and social media channels. The participants did not exhibit any clinical symptoms beyond those typically associated with postoperative cesarean section scars. A total of 26 women aged 32 to 64 years participated in the study. Six women discontinued their participation prematurely for organizational, time-related, or personal reasons. The complete data from 20 participants (aged 32 to 64 years; scar age: 0.25 to 45 years) were included in the analysis.
Inclusion criteria were the post-cesarean section condition with complete superficial wound healing between 6 weeks and 45 years postoperatively.
Participants were able to withdraw from the study at any time. The participants were informed about the conditions and objectives of the study and provided their written consent at
.
The study was designed as a prospective longitudinal study with a pre-post design. The study protocol is illustrated in Fig. 1. IBM SPSS Statistics 29 software was used to analyze the collected data. The data were tested for normal distribution (Shapiro-Wilk test), and in addition to descriptive statistics, t-tests for paired samples were performed. The significance level was set at 5%. The female participants were recruited from the patient populations of various physical therapy practices through direct outreach, local posters, and social media channels. The participants did not exhibit any clinical symptoms beyond those typically associated with postoperative cesarean section scars. A total of 26 women aged 32 to 64 years participated in the study. Six women discontinued their participation prematurely for organizational, time-related, or personal reasons. The complete data from 20 participants (aged 32 to 64 years; scar age: 0.25 to 45 years) were included in the analysis.
Inclusion criteria were the post-cesarean section condition with complete superficial wound healing between 6 weeks and 45 years postoperatively.
Participants were able to withdraw from the study at any time. The participants were informed about the conditions and objectives of the study and provided their written consent at
.
Comparison of pain and tension perception, general
well-being, and various aspects of scar assessment from a professional and patient-centered perspective at the first (T_0) and second (T_1) measurement time points. The differences between the measurement time points were tested for statistical significance (p ≤ 0.05). Effect sizes are reported using Cohen’s d.
Comparison of pain and tension perception, general
well-being, and various aspects of scar assessment from a professional and patient-centered perspective at the first (T_0) and second (T_1) measurement time points. The differences between the measurement time points were tested for statistical significance (p ≤ 0.05). Effect sizes are reported using Cohen’s d.
The SISSEL® EPIFLOW Kinesiology Tape (Sissel, Bad Dürkheim, Germany) used in this product consists of a blended textile fabric with a skin-friendly adhesive on one side and a three-part backing layer made of paper coated with "
."
The SISSEL® EPIFLOW Kinesiology Tape (Sissel, Bad Dürkheim, Germany) used in this product consists of a blended textile fabric with a skin-friendly adhesive on one side and a three-part backing layer made of paper coated with "
."
To collect the study data, participants were presented with specific questionnaires
at the test time points T_0 (before the intervention) and T_1 (after the intervention) regarding their individual perception of pain and tension, their assessment of scar quality (self-assessment), and their individual
sense of well-being. In addition, a form for the external assessment of scar quality by the treating professional was completed at both test time points. Recording values from the preceding week is intended to minimize the influence of short-term fluctuations in the participants’ well-being. Each question features a 7-point (perception of pain and tension) or a 6-point (WHO5: well-being questionnaire) and a 5-point (POSAS: scar assessment questionnaire) response options (numerical rating scale), each of which was recorded as a total score. For practical reasons, the assessment procedures were not conducted in a fixed order.
The continuous strip gently tightens the skin, creates more space within the tissue, and promotes blood circulation. Adhesions are released, and tissue mobility is improved.
To collect the study data, participants were presented with specific questionnaires
at the test time points T_0 (before the intervention) and T_1 (after the intervention) regarding their individual perception of pain and tension, their assessment of scar quality (self-assessment), and their individual
sense of well-being. In addition, a form for the external assessment of scar quality by the treating professional was completed at both test time points. Recording values from the preceding week is intended to minimize the influence of short-term fluctuations in the participants’ well-being. Each question features a 7-point (perception of pain and tension) or a 6-point (WHO5: well-being questionnaire) and a 5-point (POSAS: scar assessment questionnaire) response options (numerical rating scale), each of which was recorded as a total score. For practical reasons, the assessment procedures were not conducted in a fixed order.
The continuous strip gently tightens the skin, creates more space within the tissue, and promotes blood circulation. Adhesions are released, and tissue mobility is improved.
1. A continuous activation strip
on the back of the strap for massage
2. Skin
3. Subcutaneous tissue / adipose tissue
4. Fascia
1. A continuous activation strip
on the back of the strap for massage
2. Skin
3. Subcutaneous tissue / adipose tissue
4. Fascia
The participants underwent a 3-week treatment regimen using SISSEL® EPIFLOW Kinesiology Tape, which consisted of a self-administered home treatment program (applying the tape and performing prescribed stretching and rotating exercises). To simplify the process and illustrate the individual steps, the participants were provided with illustrated application instructions. The participants performed the application independently on 5 consecutive days each week, carrying out the prescribed intervention 3 times (morning, noon, and evening) for for approximately 3 to 5 minutes on each application day. After the fifth day of application, the tape was removed, and participants took a two-day break. The intervention was based on the content and principles of manual fascial therapy as practiced in physical therapy.
The participants underwent a 3-week treatment regimen using SISSEL® EPIFLOW Kinesiology Tape, which consisted of a self-administered home treatment program (applying the tape and performing prescribed stretching and rotating exercises). To simplify the process and illustrate the individual steps, the participants were provided with illustrated application instructions. The participants performed the application independently on 5 consecutive days each week, carrying out the prescribed intervention 3 times (morning, noon, and evening) for for approximately 3 to 5 minutes on each application day. After the fifth day of application, the tape was removed, and participants took a two-day break. The intervention was based on the content and principles of manual fascial therapy as practiced in physical therapy.
From the T_0 (pre-) to the T_1 (post-) measurement, significant improvements were observed in subjective pain and tension perception, in individual quality of life, and in patients’ overall assessments of the scar’s appearance and feel. Patients’ overall satisfaction with the scar did not improve; however, when examining the individual scores on the scar assessment questionnaire, patients rated the scar characteristics of color, texture and structure, firmness, and sensitivity to touch as significantly improved. The observer assessment of the overall quality of the scar improved only slightly; however, the characteristics of vascularity, firmness, adhesion, tension, and widening of the scar showed significant improvements. The effect sizes, which indicate the practical significance of the individual results, range from moderate to high (Fig. 3).
From the T_0 (pre-) to the T_1 (post-) measurement, significant improvements were observed in subjective pain and tension perception, in individual quality of life, and in patients’ overall assessments of the scar’s appearance and feel. Patients’ overall satisfaction with the scar did not improve; however, when examining the individual scores on the scar assessment questionnaire, patients rated the scar characteristics of color, texture and structure, firmness, and sensitivity to touch as significantly improved. The observer assessment of the overall quality of the scar improved only slightly; however, the characteristics of vascularity, firmness, adhesion, tension, and widening of the scar showed significant improvements. The effect sizes, which indicate the practical significance of the individual results, range from moderate to high (Fig. 3).
The survey results confirm previous findings that the targeted use of SISSEL® EPIFLOW Kinesiology Tape has a positive effect on
individual perceptions of pain and tension, on scar quality, and on individual well-being in women with cesarean section scars.
The present study demonstrates these positive effects in a group of female participants aged 32 to 64 with scar ages ranging from 0.25 to 45 years. These results are evident in both newer and older scars.
Due to the small number of participants, the results can only serve as a description of trends and should be interpreted with caution. Of the original 26 participating women, 6 (23%) discontinued use—and thus data collection—before the second test day. Organizational, time-related, and personal reasons were cited. In addition to the small sample size, a methodological limitation is the absence of a control group, which could have increased the internal validity. However, this study was able to identify clear effects of use. The participants’ awareness of being study participants, the supportive conditions, and intra-individual motivational factors threaten external validity; however, due to the simplicity of the intervention, it is quite possible to generalize the results to the target population. As side effects related to the application of the tape, isolated cases of mild itching of the scar and skin redness at the tape’s adhesion points were reported. In isolated cases, the tape no longer adhered reliably to the skin after showering or swimming. No pain or bothersome skin irritation was reported, suggesting that the SISSEL® EPIFLOW Kinesiology Tape and its application are well tolerated. Fundamentally, the intervention appears to be suitable for improving the condition and quality of linear surgical scars, reducing pain, and consequently enhancing the patients’ quality of life. As the number of participants increases in the further course of the study, the results can be further verified.
Future studies could be conducted with a randomized control group following a standard scar care program. By applying the technique to other linear surgical scars (e.g., following hip replacement, knee replacement, heart surgery, etc.), the effects could be further investigated.
The survey results confirm previous findings that the targeted use of SISSEL® EPIFLOW Kinesiology Tape has a positive effect on
individual perceptions of pain and tension, on scar quality, and on individual well-being in women with cesarean section scars.
The present study demonstrates these positive effects in a group of female participants aged 32 to 64 with scar ages ranging from 0.25 to 45 years. These results are evident in both newer and older scars.
Due to the small number of participants, the results can only serve as a description of trends and should be interpreted with caution. Of the original 26 participating women, 6 (23%) discontinued use—and thus data collection—before the second test day. Organizational, time-related, and personal reasons were cited. In addition to the small sample size, a methodological limitation is the absence of a control group, which could have increased the internal validity. However, this study was able to identify clear effects of use. The participants’ awareness of being study participants, the supportive conditions, and intra-individual motivational factors threaten external validity; however, due to the simplicity of the intervention, it is quite possible to generalize the results to the target population. As side effects related to the application of the tape, isolated cases of mild itching of the scar and skin redness at the tape’s adhesion points were reported. In isolated cases, the tape no longer adhered reliably to the skin after showering or swimming. No pain or bothersome skin irritation was reported, suggesting that the SISSEL® EPIFLOW Kinesiology Tape and its application are well tolerated. Fundamentally, the intervention appears to be suitable for improving the condition and quality of linear surgical scars, reducing pain, and consequently enhancing the patients’ quality of life. As the number of participants increases in the further course of the study, the results can be further verified.
Future studies could be conducted with a randomized control group following a standard scar care program. By applying the technique to other linear surgical scars (e.g., following hip replacement, knee replacement, heart surgery, etc.), the effects could be further investigated.
The targeted use of SISSEL® EPIFLOW Kinesiology Tape, following specific instructions for use, offers women with cesarean section scars for a way to positively influence pain and tension, various aspects of scar quality, and their individual quality of life. The use of SISSEL® EPIFLOW Kinesiology Tape offers users a simple and self-administered way to positively influence their scar condition through self-management. To generalize the results, controlled studies, an increase in the number of participants, and the extension of the application to other
target and user groups are necessary.
The targeted use of SISSEL® EPIFLOW Kinesiology Tape, following specific instructions for use, offers women with cesarean section scars for a way to positively influence pain and tension, various aspects of scar quality, and their individual quality of life. The use of SISSEL® EPIFLOW Kinesiology Tape offers users a simple and self-administered way to positively influence their scar condition through self-management. To generalize the results, controlled studies, an increase in the number of participants, and the extension of the application to other
target and user groups are necessary.
Funding: SISSEL , GmbH supported the participants by providing SISSEL® EPIFLOW Kinesiology Tape, study materials, illustrated exercise instructions, and exercise videos. No financial support or grants were provided.
Conflict of Interest: Uwe Mehrmann serves as a scientific consultant for SISSEL GmbH. Annegret Sattler serves as a consultant—as a physical therapist and Pilates instructor specializing in rehabilitation—for SISSEL GmbH. Ethical Principles: All procedures conducted in this study involving human participants complied with the ethical standards of the institutional and/or national research review board, as well as the 1964 Declaration of Helsinki and its subsequent amendments, or comparable ethical standards.
Informed consent: Written informed consent was obtained individually from every single participant included in the study, without exception.
References
1) Bringeland NE, Boeger D (2022): Scar Therapy (2nd ed.). Urban & Fischer
2) Pollok B (2015): Scar Massage. In: Reichert B (ed.): Massage Therapy: 290–302. Thieme Verlag
Funding: SISSEL , GmbH supported the participants by providing SISSEL® EPIFLOW Kinesiology Tape, study materials, illustrated exercise instructions, and exercise videos. No financial support or grants were provided.
Conflict of Interest: Uwe Mehrmann serves as a scientific consultant for SISSEL GmbH. Annegret Sattler serves as a consultant—as a physical therapist and Pilates instructor specializing in rehabilitation—for SISSEL GmbH. Ethical Principles: All procedures conducted in this study involving human participants complied with the ethical standards of the institutional and/or national research review board, as well as the 1964 Declaration of Helsinki and its subsequent amendments, or comparable ethical standards.
Informed consent: Written informed consent was obtained individually from every single participant included in the study, without exception.
References
1) Bringeland NE, Boeger D (2022): Scar Therapy (2nd ed.). Urban & Fischer
2) Pollok B (2015): Scar Massage. In: Reichert B (ed.): Massage Therapy: 290–302. Thieme Verlag
