Combination of Battlefield Acupuncture and Local Point Acupuncture for Post Laparotomy Scar Pain

Background: Scar pain is a residual symptom of a wound that can cause physiologic and psychologic disorders in patients. In addition to mechanical stimulation in nociceptive fibers, pain can be caused by a neuroma-an adhesion between the layers of skin and fascia that disrupts blood flow around the scar-as well as an increase in peptidergic nerve-fiber density due to dysregulation between synthesis and degradation of collagen tissue that cause abnormal scar formation. Research has shown that ear acupuncture is effective for management of acute pain, including scar pain. Acupuncture in the local area of the scar is also effective for reducing pain significantly. The combination of these 2 therapies is expected to be effective for management of scar pain in cases that have not improved for 4 years. Case: A 69-year-old woman, with a history of a laparotomy 4 years ago, came to the RSCM acupuncture outpatient unit with severe pain in her stomach. The pain was located in a 30-cm long laparotomy wound that ran between the xiphoideus process and the umbilicus, and felt like a rope binding and pressing upward in the area. Manual acupuncture was given at a Battlefield Acupuncture (BFA) point, combined with acupuncture to local point on the scar. Results: She had with a positive vascular autonomic sign response for 30 minutes at each session. At the end of her 12th therapy session, she reported that she was pain-free and did not experience any severe side-effects. Conclusion: A combination of BFA with local-point acupuncture was effective in reducing the severe pain of caused by a post-laparotomy scar.