Abstract: Objective　To observe the effect of extracorporeal shock wave therapy （ESWT） combined with ultrasound on the improvement of scar indentation and adhesion. Methods　A retrospective analysis was conducted on the clinical data of 46 patients with scar depression and adhesion who were treated at our department from January 2023 to December 2023. All patients had dynamic depression of the scar after wound healing and underwent conservative scar rehabilitation treatment at our department. According to whether ESWT was received or not， the patients were divided into control group and experimental group. The control group was treated with traditional ultrasound to improve scar adhesion， and the experimental group was treated with ESWT on the basis of ultrasound therapy. The patients’ scar skin images and thickness data were collected using a 14 MHz high-frequency ultrasound before and after treatment for 2 weeks， 4 weeks， 8 weeks， respectively. The Shore hardness meter was used to evaluate the hardness of the scars in each group， and the patients’ satisfaction with the treatment was recorded， along with any adverse events. Results　After 2 weeks， 4 weeks， and 8 weeks of treatment， the Bultrasound showed that the anterior-posterior diameter （scar thickness） of the control group and the experimental group decreased， and the change in the experimental group was more obvious （P<0.05）. After 2 weeks， 4 weeks， and 8 weeks of treatment， the hardness measured by the hardness meter in both groups showed a decrease in hardness， and the hardness of the scar in the experimental group was significantly lower than that of the control group at each time point （P<0.05）. After 2 months of treatment， the satisfaction score of experimental group was significantly higher than that of control group（ P<0.05）. There was no significant difference in the incidence of hematoma and pain between the two groups （P>0.05）. Conclusion　 ESWT treatment can effectively reduce scar thickness and improve scar hardness on the basis of ultrasound treatment， and significantly improve the treatment satisfaction of patients and their families， which is worthy of promotion in the clinical treatment of scar depression and adhesion. 

Key words: Scar adhesion, 　Extracorporeal shock wave therapy, 　Dynamic depression