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ISSN: 0959-3985 (print), 1532-5040 (electronic)

Physiother Theory Pract, 2014; 30(6): 390–398

! 2014 Informa Healthcare USA, Inc. DOI: 10.3109/09593985.2014.891068

RESEARCH REPORT

Kinesiologic taping reduces morbidity after oral and maxillofacial

surgery: a pooled analysis
Oliver Ristow, MD1,2, Christoph Pautke, MD, DDS1,2, Victoria Kehl, PhD3, Steffen Koerdt, MD2, Lilian Hahnefeld, MD1,2,
and Bettina Hohlweg-Majert, MD, DDS1,4
1
Medizin und Aesthetik, Clinic for Oral and Maxillofacial and Plastic Surgery, Munich, Germany, 2Department of Oral and Maxillofacial Surgery,
Ludwig-Maximilians Universität Munich, Germany, 3Institute of Medical Statistics and Epidemiology, Technische Universität Munich, Germany,
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and 4Department of Oral and Maxillofacial Surgery, Technische Universität Munich, Germany

Abstract Keywords
Background: Postoperative morbidity is a major disadvantage after oral and maxillofacial (OMF) Kinesiologic tape, maxillofascial, morbidity,
surgery, often caused by pain, trismus and swelling affecting patients’ quality of life. The goal of pain, quality of life, swelling
this study was to examine the effect of kinesiologic taping (KT) on swelling, pain, trismus and
patients’ satisfaction after OMF surgery. Materials and methods: Performing a pooled analysis of History
96 patients that were assigned for maxillofacial treatment (midface fractures n ¼ 30, mandibular
fractures n ¼ 26, wisdom tooth removal n ¼ 40) divided into treatment either with or without Received 30 July 2013
kinesiologic tape application. Tape was applied directly after surgery and maintained for at Revised 11 December 2013
least 5 d postoperatively. Facial swelling was quantified at six specific points in time using a Accepted 23 December 2013
five-line measurement. Pain and degree of mouth opening was measured. Patients’ objective Published online 27 February 2014
For personal use only.

feeling and satisfaction was queried. Results: Application of KT after OMF surgery has a
significant influence on the reduction of swelling decreasing the turgidity for 60% during the
first 2 d after surgery. Evaluating all patients swelling was significantly lower in the KT treatment
group (T2: 63.5 cm ± 4.3; T3: 62.5 cm ± 4.2; T4: 61.6 cm ± 4.2) than in the no-KT group
(T2: 67.6 cm ± 5.0; T3: 67.0 cm ± 5.0; T4: 64.8 cm ± 4.8) at T2 (p50.001), T3 (p50.001), and T4
(p ¼ 0.001). VAS Pain values were scored significantly lower for the KT group (T1: 2.5 ± 2.0
(p ¼ 0.006); T2: 1.7 ± 2.0 (p50.001); T3: 1.5 ± 2.3 (p ¼ 0.004); T4: 0.6 ± 1.1 (p ¼ 0.001) compared to
the no-KT group (T1: 3.8 ± 2.5; T2: 3.5 ± 2.7; T3: 2.9 ± 2.2; T4: 1.6 ± 1.7). A statistically significant
amelioration in mean mouth opening ability was observed in the KT group (T1-BL:
0.08 cm ± 0.49 (p ¼ 0.025); T2-BL: 0.07 cm ± 0.59 (p ¼ 0.012); T3-BL: 0.20 ± 0.63 (p ¼ 0.013);
T4-BL: 0.42 ± 0.59 (p ¼ 0.003)) compared to the no-KT group (T1-BL: 0.47 cm ± 0.86; T2-BL:
0.39 cm ± 0.84; T3-BL: 0.24 ± 0.89; T4-BL: 0.13 ± 1.02). Conclusion: KT after OMF surgery is a
promising, simple, less traumatic, economical approach free from systemic adverse reaction
upgrading patients’ quality of life.

Introduction modality significantly prevents the occurrence of these compli-

cations without possible undesirable side effects or considerable
Postoperative morbidity after oral and maxillofacial (OMF)
costs. Therefore, further techniques for better pain, swelling and
surgery is a major disadvantage (Folkestad, Aberg-Bengtsson,
trismus control are needed for patients who undergo OMF
and Granstrom, 2006; Miloro, 2004; Trivellato, Arnez, Sverzut,
surgery.
and Trivellato, 2011). Swelling, pain and trismus can reduce
Kinesiologic taping (KT) recently showed promising results
patient’s quality of life for several days resulting in millions of
after: third molar extraction (Ristow et al, 2013b); management of
days of sick leave per year (Colorado-Bonnin, Valmaseda-
mandibular fractures (Ristow et al, 2013a); as well as midface
Castellon, Bernini-Aytes, and Gay-Escoda, 2006; Friedman,
fractures (Ristow et al, 2013c). Therefore, the purpose of this
2007; McGrath, Comfort, Lo, and Luo, 2003). Miscellaneous
study was to examine the effect of KT on swelling, pain, trismus
methods to control the immediate inflammatory response
and patients’ satisfaction after OMF surgery and to perform a
associated with OMF surgery have been described and performed
pooled analysis of the provided data.
(Andreasen, Jensen, Schwartz, and Hillerup, 2006; Aznar-Arasa
et al, 2012; Kim et al, 2009; Markiewicz, Brady, Ding, and
Materials and methods
Dodson, 2008; Rana et al, 2013; Roynesdal, Bjornland, Barkvoll,
and Haanaes, 1993; Szolnoky et al, 2007). However, no single Patients
All patients evaluated in this pooled analysis (n ¼ 96) were
consecutively recruited, over a 12 months period. All participants
Address correspondence to Oliver Ristow, MD, Medizin und Aesthetik, were randomized into two study groups: (1) KT group; and
Clinic for Oral and Maxillofacial and Plastic Surgery, Lenbachplatz 2a, (2) no-KT group. Inclusion criteria was an operation in the
D-80333 Munich, Germany. E-mail: ristow@aesthetik-muenchen.de oralmaxillofacial area in one of the three groups: (Type 1; n ¼ 40)
 DOI: 10.3109/09593985.2014.891068 Kinesiologic taping after oral and maxillofacial surgery 391

bilateral impacted upper and lower third molars (Ristow et al,
2013b); (Type 2; n ¼ 30) zygomatico-orbital fracture and zygo-
matic-maxillary fracture involving orbital floor (Ristow et al,
2013c); and (Type 3; n ¼ 26) unilateral mandibular fractures
(Ristow et al, 2013a).
Exclusion criteria were patients younger than 18, pregnant or
lactating women, sensitivities to tape, inflammatory reactions
after surgery, unwillingness to shave facial hair and known
allergies to medication used in the study. Informed consent has
been obtained for all participants.
Surgery
All operation procedures were performed by two board-certified
specialist OMF Surgeons in general anesthesia. Surgery was
performed under sterile conditions following a standard operating
protocol as previously described (Ristow et al, 2013a, b, c).
Perioperatively, a single shot of antibiotics (Ampicillin/
Sulbactam Kabi: 2000 mg/1000 mg) was applied. All patients
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after the surgical 3 M removal and prior to patients waking up
from anesthesia. The skin was cleaned, shaved if necessary, and
any residual moisture and oil removed. All tape applications were
performed using skin colored K-Active Tape ClassicÕ , 50 mm
 5 m (K-Active Europe GmbH, Wiesthal, Germany). Tape length
was customized for each patient, defined by the distance (in the
stretched position) between the clavicle and the position of most
severe swelling. The base of three strips (of equal length ± 1.5 cm)
was placed just above the supraclavicular nodes (the target area
for drainage). Placement of the lymphatic strips was directed by
the location of the lymphatic duct crossing the cervical, sub
mental, mandibular, submandibular, preauricular and parotid
nodes to the area of maximum swelling (Figure 1a). The tape
was gently rubbed to activate the medical grade acrylic adhesive
and remained for at least 5 d.
Measurements
All measurements, performed by the same investigators (O.R. and

were treated as inpatients and received the routine postoperative L.H.), were conducted at six specific time points: (1) pre-
instructions. Both study groups received ice packs in 30-min operative (T-1); (2) immediately after the operation
intervals for 6 h after surgery and analgesic and anti-inflammatory (T0 ¼ baseline); (3) the first (T1); (4) second (T2); (5) third
medication (Diclofenac: 50 mg) every 8 h for 3 d. (T3); and (6) seventh (T4) postoperative day.

Taping Swelling measurement

All taping procedures were performed by the same investigator, a Swelling was assessed by means of a five-line measurement using
certified K-Taping therapist. The tape was applied immediately a flexible plastic tape measure (accuracy ± 0.5 mm): (1) (Line 1)
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Figure 1. (a) Kinesiologic Tape application from supraclavicular to the point of maximum swelling. Tape stripes stimulate drainage of swelling
and hematoma following the lymphatic duct. (b) Five-line measurement. Note, segments endpoints were marked to ensure accurate measurements.
(c) Inter-incisor Distance (IID) was measured using a caliper. (d) Convolutions below the taped area caused by the elasticity of the applied tape
subsequently recoiling back to its original length following the application.
 392 O. Ristow et al.
the most posterior point of the tragus to the most lateral point of
the lip commissure; (2) (Line 2) the most posterior point of the
tragus to the pogonium; (3) (Line 3) the most posterior point of
the tragus to the lateral canthus of the eye; (4) (Line 4) the lateral
canthus of the eye to the most inferior point angle of the
mandible; and (5) (Line 5) the most inferior point angle of the
mandible to the mid-point of the nasal bone (Figure 1b). End
points were marked using a fine waterproof felt tip pen
(for subsequent tape measurements).
Pain measures
Pain scores were assessed using a 10 level Visual Analogue Scale
(VAS) subdivided in 10 mm increments, where: 0 indicates no
pain; 5 – moderate pain; and 10 – severe pain. Patients were asked
to place a mark along the line to specify their pain sensation.
Trismus measures
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The maximal mouth opening (maximum interincisal distance;
IID) was recorded using calipers (Figure 1c).
Subjective outcome measures
Patients were asked to judge whether: (1) they find the tape not
disturbing ¼ 1, slightly disturbing ¼ 2, or very disturbing ¼ 3;
(2) they find the tape does not ¼ 1, only slightly ¼ 2, or
significantly ¼ 3 interfere with their movements; (3) the degree
of swelling was negligible ¼ 1, subtle ¼ 2, or severe ¼ 3; and
(4) the taping therapy was very satisfying and convenient ¼ 1,
satisfying ¼ 2, or not satisfying ¼ 3. Patients completed their
For personal use only.
questionnaires at the same time points as the rest of the
measurements occurred.
Statistical analysis
All statistical analyses were performed using IBM SPSS Statistics
software (Version 21.0). The variable of primary interest was
swelling in 2 groups of patients: (1) Group 1 bilateral impacted
upper and lower third molars described as the Oral group; and
(2) Group 2 consisting of zygoatico-orbital and zygomatic-
maxillary fracture involving orbital floor and unilateral mandibu-
lar fracture described as Facial group. These two groups were not
compared against one another. These two groups of patients were
then independently (block) randomized and either received
kinesiologictaping (KT group) or not (no KT group). The
statistical comparison was for the taping condition. Results are
reported for the entire sample (i.e. Group 1 and 2 combined) and
separately for the oral and facial group comparing the KT to no
KT treatment. This was a repeated measures design with six
measures taken (pre-op; immediately post-surgery; and at day 1,
2, 3, and 7 post surgery). The analysis performed for the entire
sample was a repeated measures ANOVA design with 2 factors
(treatment – KT or no KT and time – six measures). Main effects
are thus treatment and time with the major interest in the
interaction. Post-hoc analysis (t-tests with Bonferroni–Holm
adjustment) was performed if there was a significant interaction
to determine where differences existed between the treatments at
the different time points. Similar analyses were performed for the
Oral group and the Facial group to explore if these groups
behaved in a similar fashion to one another. For the repeated
measure ANOVAs the significance level was set to be 0.05.
Post-hoc comparisons were also performed with global a of 0.05.
The variables of secondary interest were pain and also
maximal mouth opening. The same repeated measures ANOVA
was performed for the entire combined group and for the oral and
facial groups. The overall significance level was set to 0.05. All
statistical tests were performed in an exploratory manner.
Physiother Theory Pract, 2014; 30(6): 390–398
Results
Swelling
All swelling measurements were expressed as the sum of all
five-line measurements (Line 1 through Line 5) for all patients
and for Group 1 (oral; Type 1) and Group 2 (facial; Type 2 and
Type 3) (Ristow et al, 2013a, b, c) at the six specific time points
(Figure 2).
The repeated measures ANOVA produced the following
results. Treatment, regardless of time (main effect of
treatment), had an effect on swelling for the total sample
(p ¼ 0.005) and the subgroup of facial surgeries (p50.001),
but not for the group of oral surgeries. Time, regardless of
treatment (main effect of time) had an effect on swelling in the
total sample, as well as in each of the two surgery type groups
(p50.001 for each).
There was also a significant interaction between treatment and
time on swelling for the total sample (p50.001), for the oral
group (p50.001), and for the facial group (p50.001). Figure 2(a)
includes the tests for differences between treatments for each of
the six time points, denoted with a star for each time point with
Bonferroni–Holm adjusted significance. Mean sum of all five-line
measurements for all patients showed no statistically significant
difference preoperatively (T-1), directly after operation at baseline
measurement (T0), and on day one after surgery (T1) comparing
KT group (T-1: 62.0 cm ± 4.4; T0: 65.2 cm ± 4.5; T1:
65.2 cm ± 4.6) and no-KT group (T-1: 63.0 cm ± 4.4; T0:
65.3 cm ± 4.3; T1: 67.3 cm ± 4.7). Swelling was significantly
lower in the KT treatment group after day 2 through day 7
post-surgery (T2: 63.5 cm ± 4.3; T3: 62.5 cm ± 4.2; T4:
61.6 cm ± 4.2) than in the no-KT group (T2: 67.6 cm ± 5.0; T3:
67.0 cm ± 5.0; T4: 64.8 cm ± 4.8) at T2 (p50.001), T3
(p50.001), and T4 (p ¼ 0.001).
The oral group showed no significant differences, although a
numerical trend for T2 and T3 could be seen (Figure 2b). The
facial group (Figure 2c) showed even stronger differences
between the KT and no-KT groups than seen in the overall
sample. In the facial group there was a statistically significant
difference already at T1 (p ¼ 0.005).
Pain
KT and the no-KT group results for pain scores assessed by means
of a 10 level VAS are shown in Figure 3.
Treatment, regardless of time (main effect of treatment), had
an effect on VAS for the total sample (p ¼ 0.001) and the
subgroup of oral surgeries (p50.001), but not for the group of
facial surgeries. Time, regardless of treatment (main effect of
time), had an effect on VAS in the total sample, as well as in each
of the two surgery type groups (p50.001 for each).
There was also an interaction between treatment and time on
VAS for the total sample (p ¼ 0.012) and for the oral group
(p ¼ 0.001), but not for the facial group. The mean of all VAS
scores for all patients (Figure 3a) (Type 1–3) showed no
statistically significant difference preoperatively (T-1) and dir-
ectly after operation at the baseline measurement (T0) in the KT
group (T-1: 0.7 ± 0.9; T0: 2.0 ± 2.2) and the no-KT group (T-1:
1.0 ± 1.1; T0: 2.5 ± 1.8). Although the mean sum of all VAS
scores for all patients (Type 1–3) were low to moderate, patients
of the KT group scored significantly lower VAS values
(T1: 2.5 ± 2.0 (p ¼ 0.006); T2: 1.7 ± 2.0 (p50.001); T3:
1.5 ± 2.3 (p ¼ 0.004); T4: 0.6 ± 1.1 (p ¼ 0.001) compared to
their no-KT counterparts (T1: 3.8 ± 2.5; T2: 3.5 ± 2.7; T3:
2.9 ± 2.2; T4: 1.6 ± 1.7). Similar results were observed in the
oral group (Figure 3b). No differences were found in the facial
surgery group (Figure 3c).
 DOI: 10.3109/09593985.2014.891068 Kinesiologic taping after oral and maxillofacial surgery 393
Figure 2. Mean sum of all five-line
measurements (a) for all patients, (b) Group
1 (oral; Type 1) and (c) Group 2 (facial; Type
2 and Type 3) comparing KT (black
error-bars) and no-KT group (grey error-bars)
at six specific measurement times (T-1:
Pre-operative; T0: Baseline directly after
operation; T1: first; T2: second; T3: third;
T4: seventh postoperative day). Included are
the tests for differences between treatments
for each of the six time points, denoted
with a star for each time point with
Bonferroni–Holm adjusted significance.
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Trismus
Treatment, regardless of time (main effect of treatment), had an
effect on trismus for the total sample (p ¼ 0.041) and the subgroup
of oral surgeries (p ¼ 0.001), but not for the group of facial
surgeries (Figure 4). Time, regardless of treatment (main effect of
time) had an effect on trismus in the total sample, as well as in the
oral surgery type group (p50.001 for each). No time effect was
observed in the facial surgery group.
There was an interaction between treatment and time on
trismus for the total sample (p ¼ 0.001) (Figure 4a) and for the
 394 O. Ristow et al. Physiother Theory Pract, 2014; 30(6): 390–398

Figure 3. Mean VAS scores (a) for all

patients, (b) Group 1 (oral; Type 1) and
(c) Group 2 (facial; Type 2 and Type 3)
comparing KT (black error-bars) and no-KT
group (grey error-bars) at six specific
measurement times. Included are the tests for
differences between treatments for each of
the six time points, denoted with a star for
each time point with Bonferroni–Holm
adjusted significance.
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oral group (p ¼ 0.005) (Figure 4b), but not for the facial group However, mouth opening ability was higher in the KT group
(Figure 4c). Mouth opening ability preoperatively (T-1) and at (T1: 3.5 ± 1.4; T2: 3.6 ± 1.3; T3: 3.8 ± 1.2; T4: 4.0 ± 1.2)
baseline (T0) did not differ between the KT group (T-1: 3.8 ± 1.6; compared to the no-KT group (T1: 2.9 ± 1.2; T2: 3.0 ± 1.3;
T0: 3.6 ± 1.5) and the no-KT group (T-1: 3.6 ± 1.1; T0: 3.4 ± 1.1). T3: 3.1 ± 1.3; T4: 3.2 ± 1.2) for T1 (p ¼ 0.025), T2 (p ¼ 0.012),
 DOI: 10.3109/09593985.2014.891068 Kinesiologic taping after oral and maxillofacial surgery 395
Figure 4. Mean IID scores (a) for all patients,
(b) Group 1 (oral; Type 1) and (c) Group 2
(facial; Type 2 and Type 3) comparing KT
(black error-bars) and no-KT group (grey
error-bars) at six specific measurement times.
Included are the tests for differences between
treatments for each of the six time points,
denoted with a star for each time point with
Bonferroni–Holm adjusted significance.
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For personal use only.
 396 O. Ristow et al. Physiother Theory Pract, 2014; 30(6): 390–398

Table 1. Subjective outcome measures: Patients satisfaction T3 (p ¼ 0.013), and T4 (p ¼ 0.003). After adjustment for multiple
self-assessment. comparisons, only the treatment differences at T4 were significant
for the overall sample (Figure 4a).
KT
Yes No Patient self-assessment
N N% N N% Patient satisfaction scores were essentially interchangeable
Satisfaction self-assessment
between the two groups at T0, but stark differences were observed
T0 Very satisfied 24 50.0 22 45.8 from T1 onwards. Satisfaction rates steadily increased in patients
Satisfied 18 37.5 21 43.8 from the KT group, conversely in the no-KT group dissatisfaction
Not satisfied 6 12.5 5 10.4 rose and peaked at T2 then declined. Analogous results were
T1 Very satisfied 20 41.7 11 22.9 observed with the self-assessment of swelling, namely the no-KT
Satisfied 23 47.9 17 35.4 group experienced proportionally more swelling (which peaked
Not satisfied 5 10.4 20 41.7
at T2) than the KT group. It should be noted that, overall, patients
T2 Very satisfied 28 58.3 6 12.5
Satisfied 18 37.5 19 39.6 did not feel overly affected (in terms of restriction in movement
Not satisfied 2 4.2 23 47.9 and general disturbance) by the tape, however, discomfort
T3 Very satisfied 35 72.9 12 25.0 seemingly increased slightly at the later time points (T3 and
Satisfied 10 20.8 22 45.8 T4) (Table 1).
Not satisfied 3 6.3 14 29.2
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T4 Very satisfied 42 87.5 24 50.0 Discussion

Satisfied 3 6.3 20 41.7
Not satisfied 3 6.3 4 8.3 Our pooled analysis shows that the clinical application of
Swelling self-assessment KT after OMF surgery has a statistically significant influence
T0 Negligible swelling 26 54.2 22 45.8 on all investigated parameters: swelling; pain; and trismus.
Subtle swelling 15 31.3 16 33.3 Furthermore, patients with KT report a significantly lower
Severe swelling 7 14.6 10 20.8
morbidity rate.
T1 Negligible swelling 20 41.7 5 10.4
Subtle swelling 15 31.3 20 41.7 Postoperative swelling is a common event after OMF
Severe swelling 13 27.1 23 47.9 surgery affecting the social and working life of patients.
T2 Negligible swelling 29 60.4 2 4.2 Therefore, it is in the patient’s interest to alleviate the post-
Subtle swelling 14 29.2 19 39.6 operative discomfort after the surgery and a multitude of studies
Severe swelling 5 10.4 27 56.3 have investigated how best to control postoperative side effects in
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T3 Negligible swelling 31 64.6 7 14.6 oral surgery (Greenstein, 2007; Kim et al, 2009; Markiewicz,
Subtle swelling 14 29.2 23 47.9
Severe swelling 3 6.3 18 37.5 Brady, Ding, and Dodson, 2008; Rana et al, 2011; Szolnoky
T4 Negligible swelling 40 83.3 22 45.8 et al, 2007).
Subtle swelling 8 16.7 22 45.8 After its introduction in the 1970s by Dr K. Kase, KT has
Severe swelling 0 0.0 4 8.3 become a popular procedure used in sports medicine to prevent or
KT disturbance treat injuries (Kase, Wallis, and Kase, 2003; Williams, Whatman,
T0 Not disturbing 48 100.0 Hume, and Sheerin, 2012). Furthermore, the use of KT in the
Slightly disturbing 0 0.0 management of lymphedema is gaining popularity (Sijmonsma,
Very disturbing 0 0.0 Trompert, and van der Veen, 2010). The general idea is that KT is
T1 Not disturbing 41 85.4
Slightly disturbing 7 14.6
lifting the skin thus improving blood and lymph flow, removing
Very disturbing 0 0.0 congestion of lymphatic fluid or hemorrhage. Providing space,
T2 Not disturbing 32 66.7 fluids are encouraged to move from areas of higher pressure
Slightly disturbing 16 33.3 towards areas of lower pressure, guided by the tape to the desired
Very disturbing 0 0.0 direction of drainage (Kase, Wallis, and Kase, 2003). However,
T3 Not disturbing 29 60.4 there is a significant clinical and practical experience in this
Slightly disturbing 17 35.4
approach but little published controlled research. Indeed, while
Very disturbing 2 4.2
T4 Not disturbing 29 60.4 some reports and case studies offer circumstantial evidence that
Slightly disturbing 15 31.3 KT influences swelling and hemorrhage rates, the vast majority
Very disturbing 4 8.3 fail to support the observed clinical effects with sound evidence-
KT Affection based results (Chou, Li, Liao, and Tang, 2012; Luhr, 1987; Sahoo
T0 Not 47 97.9 and Mohan, 2010; Tsai et al, 2009; Williams, Whatman, Hume,
Slightly 1 2.1 and Sheerin, 2012). To the best of our knowledge, we are the
Significantly 0 0.0 first to report the clinical use of KT following OMF surgery
T1 Not 38 79.2 (Ristow et al, 2013a, b, c).
Slightly 9 18.8
Significantly 1 2.1 The present pooled analysis demonstrates that application of
T2 Not 31 64.6 KT significantly influences tissue reactions and the rate of
Slightly 16 33.3 swelling. The post-operative increase of swelling at day two after
Significantly 1 2.1 surgery, was significantly lower in the KT group than the no-KT
T3 Not 27 56.3 group. Very similar results were observed on day three as well.
Slightly 19 39.6 Maximum swelling typically occurs around the second post-
Significantly 2 4.2
T4 Not 26 54.2
operative day, which is in line with the results obtained from our
Slightly 18 37.5 control group. However, by applying KT, swelling peaked
Significantly 4 8.3 significantly earlier (within 24 h of surgery) and the reduction in
magnitude was significantly faster (in excess of 60% during the
Shown are results as absolute answers (N) and percentage (N%) for first 2 d after surgery). These findings are most likely due to KT’s
all patients (Type 1–3) comparing KT and no-KT group at five thickness (which is not dissimilar to human skin), adhesion and
measurement times.
 DOI: 10.3109/09593985.2014.891068
stretch capacity. KT can stretch up to 140% of its original
length and subsequently recoils back to its original length.
When applied correctly, this feature generates a pulling force
resulting in the characteristic skin convolutions below the taped
area (Figure 1d), which in turn are thought to increase the
interstitial space between the skin and underlying connective
tissue, thus promoting the follow of blood and lymphatic fluid
(Sijmonsma, Trompert, and van der Veen, 2010). Furthermore, by
using KT, maximal mouth opening ability recovered more rapidly,
possibly due to the swelling receding faster and thereby
alleviating skin tension.
Using KT, patients mouth opening increased faster after
the operation than in the no-KT group. The following results
were seen in our subjective findings that patients in the KT
group had higher satisfaction after the operation compared to
the no-KT group. This might be because the swelling
resolves faster, taking the tension from the skin. In addition, KT
effected pain perception. Both study groups received the
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same standardized postoperative analgesic drug therapy, which
may explain why patients from both groups scored moderate
to negligible pain (VAS55) at all six time points investigated.
Nevertheless and also in agreement with other reports (Gonzalez-
Iglesias et al, 2009; Thelen, Dauber, and Stoeman, 2008),
statistically significant KT-dependent reduction of pain was
observed in this study. Movement stretches KT, it adjusts its
length to that of the skin only to an extent, and thus deforms
the skin. This constant impulse stimulates the skin and may
divert patients’ pain perception. In addition, based on the
subjective scoring scheme, the perceived postoperative swelling
was lower and overall satisfaction rate was higher in patients
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from the KT group. The present study design cannot exclude
possible placebo effects and therefore we cannot proclaim with
absolute confidence that KT is able to significantly reduce
the perception of pain. Further targeted experimentation, for
example by removing the effect of the standardized analgesic or
by the provision of rescue drugs, is needed to substantiate this
notion.
Facial volume reduction assessment is one of the greatest
obstacles for a reliable and objective demonstration of treatment.
Although numerous methods have been tried, most are imprecise,
complex, expensive or difficult to standardize (Bjorn, Lundqvist,
and Hjelstrom, 1954; Milles, Desjardins, and Pawel, 1985; Van
Gool, Ten Bosch, and Boering, 1975). We tried to quantify the
changes in facial volume using a modified method of linear
measurements. Applying a series of data points, utilizing defined
landmarks covering the whole facial area of interest. By marking
the segments endpoints, great care was taken to always measure
the same distances. Furthermore, measurements were only carried
out by two of the investigators prohibiting unwanted measurement
variance.
Finally, it is conceivable that in some cases the application of
tape may irritate the skin, and similarly, some patients may show
allergic reactions to the adhesives. Although no incidence of
adverse reactions were observed in our study, this should be
confirmed prior to any wide-spread and routine use.
Conclusion
In summary, KT after OMF surgery is a promising, simple, less
traumatic method free from adverse reactions that: (1) upgrades
the patient’s quality of life; and (2) represents a potentially
substantial economic benefit.
Acknowledgements
We thank the K-Active Europe GmbH for the donation of all K-Active
TapesÕ used in this study.
Kinesiologic taping after oral and maxillofacial surgery 397
Declaration of interest
The authors report no declarations of interest.
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