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Managing Scars: Measurements to Improve Scar Management

  • Luc Téot
  • Claude Roques
  • Sami Otman
  • Antonio Brancati
  • Rainer Mittermayr
Chapter

Abstract

Pathological scarring is a common condition in daily clinical routine and potentially constrains affected patients in both aesthetically and functionally. To treat these patients adequately the different types of scars have to be evaluated accurately and continuously. Several qualitative and quantitative tools are available to categorize the type and severity of scars and to monitor the efficacy of treatment. This article reviews currently available measures to evaluate individual scars subjectively and objectively.

Keywords

Scar Scar Assessment Scales Vancouver Scar Scale Seattle Scar Scale Manchester Scar Scale POSAS Stony Brook Scar Scale Tristimulus System Narrow band simple reflectance meter Laser Doppler Planimetry TUPS 

References

  1. 1.
    Teot L. Clinical evaluation of scars. Wound Repair Regen. 2002;10(2):93–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res. 2002;11(3):193–205.Google Scholar
  3. 3.
    Keszei AP, Novak M, Streiner DL. Introduction to health measurement scales. J Psychosom Res. 2010;68(4):319–23.PubMedCrossRefGoogle Scholar
  4. 4.
    Durani P, McGrouther DA, Ferguson MW. Current scales for assessing human scarring: a review. J Plast Reconstr Aesthet Surg. 2009;62(6):713–20.PubMedCrossRefGoogle Scholar
  5. 5.
    Garcia-Velasco M, Ley R, Mutch D, Surkes N, Williams HB. Compression treatment of hypertrophic scars in burned children. Can J Surg. 1978;21(5):450–2.PubMedGoogle Scholar
  6. 6.
    Smith GM, Tompkins DM, Bigelow ME, Antoon AY. Burn-induced cosmetic disfigurement: can it be measured reliably? J Burn Care Rehabil. 1988;9(4):371–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Leung KS, Sher A, Clark JA, Cheng JC, Leung PC. Microcirculation in hypertrophic scars after burn injury. J Burn Care Rehabil. 1989;10(5):436–44.PubMedCrossRefGoogle Scholar
  8. 8.
    Sullivan T, Smith J, Kermode J, McIver E, Courtemanche DJ. Rating the burn scar. J Burn Care Rehabil. 1990;11(3):256–60.PubMedCrossRefGoogle Scholar
  9. 9.
    Baryza MJ, Baryza GA. The Vancouver Scar Scale: an administration tool and its interrater reliability. J Burn Care Rehabil. 1995;16(5):535–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Nedelec B, Shankowsky HA, Tredget EE. Rating the resolving hypertrophic scar: comparison of the Vancouver Scar Scale and scar volume. J Burn Care Rehabil. 2000;21(3):205–12.PubMedCrossRefGoogle Scholar
  11. 11.
    Yeong EK, Mann R, Engrav LH, Goldberg M, Cain V, Costa B, Moore M, Nakamura D, Lee J. Improved burn scar assessment with use of a new scar-rating scale. J Burn Care Rehabil. 1997;18(4):353–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Beausang E, Floyd H, Dunn KW, Orton CI, Ferguson MW. A new quantitative scale for clinical scar assessment. Plast Reconstr Surg. 1998;102(6):1954–61.PubMedCrossRefGoogle Scholar
  13. 13.
    Bayat A, McGrouther DA. Clinical management of skin scarring. Skinmed. 2005;4(3):165–73.PubMedCrossRefGoogle Scholar
  14. 14.
    Bayat A, McGrouther DA, Ferguson MW. Skin scarring. BMJ. 2003;326(7380):88–92.PubMedCrossRefGoogle Scholar
  15. 15.
    Martin D, Umraw N, Gomez M, Cartotto R. Changes in subjective vs objective burn scar assessment over time: does the patient agree with what we think? J Burn Care Rehabil. 2003;24(4):239–44.PubMedCrossRefGoogle Scholar
  16. 16.
    Draaijers LJ, Tempelman FR, Botman YA, Tuinebreijer WE, Middelkoop E, Kreis RW, van Zuijlen PP. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg. 2004;113(7):1960–5.PubMedCrossRefGoogle Scholar
  17. 17.
    van de Kar AL, Corion LU, Smeulders MJ, Draaijers LJ, van der Horst CM, van Zuijlen PP. Reliable and feasible evaluation of linear scars by the patient and observer scar assessment scale. Plast Reconstr Surg. 2005;116(2):514–22.PubMedCrossRefGoogle Scholar
  18. 18.
    Singer AJ, Arora B, Dagum A, Valentine S, Hollander JE. Development and validation of a novel scar evaluation scale. Plast Reconstr Surg. 2007;120(7):1892–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Draaijers LJ, Tempelman FR, Botman YA, Kreis RW, Middelkoop E, van Zuijlen PP. Colour evaluation in scars: tristimulus colorimeter, narrow-band simple reflectance meter or subjective evaluation? Burns. 2004;30(2):103–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Gavroy JR, Poveda K, Oversteyns A, Plantier W, Rougé D, Griffe O, Téot L, Costagliola M, Ster F. Intérêt du « test de vitro pression » dans le suivi des cicatrices de brûlures à partir de 50 observations. Ann Burns Fire Disasters. 1995;8(1):28–9.Google Scholar
  21. 21.
    Roques C, Curtet A, Druilhe E, Prieur F, Redlinger A, Guoyt L, Téot L, Griffe O. Évaluation de la couleur des cicatrices de brûlures par vision artificielle; étude préliminaire. Brûlures. 2002;3(1):16–20.Google Scholar
  22. 22.
    Davey RB, Sprod RT, Neild TO. Computerised colour: a technique for the assessment of burn scar hypertrophy. A preliminary report. Burns. 1999;25(3):207–13.PubMedCrossRefGoogle Scholar
  23. 23.
    Westerhof W. CIE colorimetry. In: Serup J, Jemec GBE, editors. Handbook of non-invasive methods and the skin. Boca Raton: CRC Press; 1995. p. 385–97.Google Scholar
  24. 24.
    Serup J, Agner T. Colorimetric quantification of erythema – a comparison of two colorimeters (Lange Micro Color and Minolta Chroma Meter CR-200) with a clinical scoring scheme and laser-Doppler flowmetry. Clin Exp Dermatol. 1990;15(4):267–72.PubMedCrossRefGoogle Scholar
  25. 25.
    Li-Tsang CW, Lau JC, Liu SK. Validation of an objective scar pigmentation measurement by using a spectrocolorimeter. Burns. 2003;29(8):779–84.PubMedCrossRefGoogle Scholar
  26. 26.
    Taylor S, Westerhof W, Im S, Lim J. Noninvasive techniques for the evaluation of skin color. J Am Acad Dermatol. 2006;54(5 Suppl 2):S282–90.PubMedCrossRefGoogle Scholar
  27. 27.
    Oliveira GV, Chinkes D, Mitchell C, Oliveras G, Hawkins HK, Herndon DN. Objective assessment of burn scar vascularity, erythema, pliability, thickness, and planimetry. Dermatol Surg. 2005;31(1):48–58.PubMedCrossRefGoogle Scholar
  28. 28.
    van Zuijlen PP, Angeles AP, Kreis RW, Bos KE, Middelkoop E. Scar assessment tools: implications for current research. Plast Reconstr Surg. 2002;109(3):1108–22.PubMedCrossRefGoogle Scholar
  29. 29.
    Fullerton A, Fischer T, Lahti A, Wilhelm KP, Takiwaki H, Serup J. Guidelines for measurement of skin colour and erythema. A report from the Standardization Group of the European Society of Contact Dermatitis. Contact Dermatitis. 1996;35(1):1–10.PubMedCrossRefGoogle Scholar
  30. 30.
    Monstrey S, Hoeksema H, Verbelen J, Pirayesh A, Blondeel P. Assessment of burn depth and burn wound healing potential. Burns. 2008;34(6):761–9.PubMedCrossRefGoogle Scholar
  31. 31.
    Stewart CJ, Frank R, Forrester KR, Tulip J, Lindsay R, Bray RC. A comparison of two laser-based methods for determination of burn scar perfusion: laser Doppler versus laser speckle imaging. Burns. 2005;31(6):744–52.PubMedCrossRefGoogle Scholar
  32. 32.
    Crowe JM, Simpson K, Johnson W, Allen J. Reliability of photographic analysis in determining change in scar appearance. J Burn Care Rehabil. 1998;19(2):183–6.PubMedCrossRefGoogle Scholar
  33. 33.
    Timar-Banu O, Beauregard H, Tousignant J, Lassonde M, Harris P, Viau G, Vachon L, Levy E, Abribat T. Development of noninvasive and quantitative methodologies for the assessment of chronic ulcers and scars in humans. Wound Repair Regen. 2001;9(2):123–32.PubMedCrossRefGoogle Scholar
  34. 34.
    Nedelec B, Correa JA, Rachelska G, Armour A, LaSalle L. Quantitative measurement of hypertrophic scar: interrater reliability and concurrent validity. J Burn Care Res. 2008;29(3):501–11.PubMedCrossRefGoogle Scholar
  35. 35.
    Lau JC, Li-Tsang CW, Zheng YP. Application of tissue ultrasound palpation system (TUPS) in objective scar evaluation. Burns. 2005;31(4):445–52.PubMedCrossRefGoogle Scholar
  36. 36.
    Roques C, Teot L, Frasson N, Meaume S. PRIMOS: an optical system that produces three-dimensional measurements of skin surfaces. J Wound Care. 2003;12(9):362–4.PubMedGoogle Scholar
  37. 37.
    Taylor B, McGrouther DA, Bayat A. Use of a non-contact 3D digitiser to measure the volume of keloid scars: a useful tool for scar assessment. J Plast Reconstr Aesthet Surg. 2007;60(1):87–94.PubMedCrossRefGoogle Scholar
  38. 38.
    Rodrigues L. EEMCO guidance to the in vivo assessment of tensile functional properties of the skin. Part 2: instrumentation and test modes. Skin Pharmacol Appl Skin Physiol. 2001;14(1):52–67.PubMedCrossRefGoogle Scholar
  39. 39.
    Esposito G, Ziccardi P, Scioli M, Pappone N, Scuderi N. The use of a modified tonometer in burn scar therapy. J Burn Care Rehabil. 1990;11(1):86–90.PubMedCrossRefGoogle Scholar
  40. 40.
    Corica GF, Wigger NC, Edgar DW, Wood FM, Carroll S. Objective measurement of scarring by multiple assessors: is the tissue tonometer a reliable option? J Burn Care Res. 2006;27(4):520–3.PubMedCrossRefGoogle Scholar
  41. 41.
    Lye I, Edgar DW, Wood FM, Carroll S. Tissue tonometry is a simple, objective measure for pliability of burn scar: is it reliable? J Burn Care Res. 2006;27(1):82–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Cleary C, Sanders AK, Nick TG. Reliability of the skin compliance device in the assessment of scar pliability. J Hand Ther. 2007;20(3):232–7.PubMedCrossRefGoogle Scholar
  43. 43.
    Romanelli M, Falanga V. Use of a durometer to measure the degree of skin induration in lipodermatosclerosis. J Am Acad Dermatol. 1995;32(2 Pt 1):188–91.PubMedCrossRefGoogle Scholar
  44. 44.
    Magliaro A, Romanelli M. Skin hardness measurement in hypertrophic scars. Wounds. 2003;15(3):66–70.Google Scholar
  45. 45.
    Falanga V, Bucalo B. Use of a durometer to assess skin hardness. J Am Acad Dermatol. 1993;29(1):47–51.PubMedCrossRefGoogle Scholar
  46. 46.
    Leblanc N, Falabella A, Murata H, Hasan A, Weiss E, Falanga V. Durometer measurements of skin induration in venous disease. Dermatol Surg. 1997;23(4):285–7.PubMedCrossRefGoogle Scholar
  47. 47.
    Draaijers LJ, Botman YA, Tempelman FR, Kreis RW, Middelkoop E, van Zuijlen PP. Skin elasticity meter or subjective evaluation in scars: a reliability assessment. Burns. 2004;30(2):109–14.PubMedCrossRefGoogle Scholar
  48. 48.
    Boyce ST, Supp AP, Wickett RR, Hoath SB, Warden GD. Assessment with the dermal torque meter of skin pliability after treatment of burns with cultured skin substitutes. J Burn Care Rehabil. 2000;21(1 Pt 1):55–63.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  • Luc Téot
    • 1
  • Claude Roques
    • 2
  • Sami Otman
    • 3
  • Antonio Brancati
    • 3
  • Rainer Mittermayr
    • 4
  1. 1.Wound Healing Unit, Department of SurgeryMontpellier University HospitalMontpellier, HéraultFrance
  2. 2.Département of Physical Therapy, Pediatric Rehabilitation CentreCSRE Lamalou le HautLamalou les BainsFrance
  3. 3.Wound Healing Medico-Surgical Unit Burns UnitMontpellier University Hospital (MUH)MontpellierFrance
  4. 4.Department of Wound Healing, AUVA Research CenterLudwig Boltzmann Institute for Experimental and Clinical TraumatologyViennaAustria

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