van de Kar Annekatrien L, Corion Leonard U M, Smeulders Mark J C, Draaijers Lieneke J, van der Horst Chantal M A M, van Zuijlen Paul P M
Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Plast Reconstr Surg. 2005 Aug;116(2):514-22. doi: 10.1097/01.prs.0000172982.43599.d6.
Although scar evaluation tools are necessary for an evidence-based approach to scar management, there is as yet no generally accepted tool. The Patient and Observer Scar Assessment Scale was developed recently and found to be a useful subjective evaluation tool for burn scars. The authors tested the Patient and Observer Scar Assessment Scale on linear scars, the largest category of surgical scars.
One hundred linear surgical scars were assessed by three independent observers using the observer scale to evaluate vascularity, pigmentation, thickness, relief, pliability, and surface area. The patients evaluated their scars simultaneously and 2 weeks later using the patient scale for the following parameters: pain, itching, color, stiffness, thickness, and relief.
The internal consistency of the observer and patient scales was good (Cronbach's alpha = 0.86 and 0.90, respectively). The reliability of the observer scale was good for the total score (r = 0.96, p < 0.001) and separate items (r > 0.86, p < 0.001) for three observers. Even a single observer evaluated scars reliably with respect to the total score (r = 0.88, p < 0.001) and the items vascularity, pigmentation, thickness, and surface area (r > 0.70, p < 0.001). The patient's intraobserver reliability was good for the total score (r = 0.94, p < 0.001) and separate items (r > 0.89, p < 0.001). The coefficient of variation of the total score was 10.4 percent for the observer scale and 15.8 percent for the patient scale, indicating good agreement.
The Patient and Observer Scar Assessment Scale is an appropriate subjective tool for the evaluation of linear scars.
尽管瘢痕评估工具对于基于循证的瘢痕管理方法是必要的，但目前尚无普遍接受的工具。患者和观察者瘢痕评估量表是最近开发的，被发现是一种用于烧伤瘢痕的有用主观评估工具。作者在线状瘢痕（手术瘢痕的最大类别）上测试了患者和观察者瘢痕评估量表。
由三名独立观察者使用观察者量表对100条线状手术瘢痕进行评估，以评估血管分布、色素沉着、厚度、平整度、柔韧性和表面积。患者在同一时间以及2周后使用患者量表对以下参数评估其瘢痕：疼痛、瘙痒、颜色、硬度、厚度和平整度。
观察者量表和患者量表的内部一致性良好（克朗巴哈系数分别为0.86和0.90）。观察者量表的总评分信度良好（r = 0.96，p < 0.001），三名观察者对各分项的评分信度也良好（r > 0.86，p < 0.001）。即使是单一观察者对瘢痕总评分（r = 0.88，p < 0.001）以及血管分布、色素沉着、厚度和表面积等项目的评分也具有可靠性（r > 0.70，p < 0.001）。患者的观察者内信度在总评分方面良好（r = 0.94，p < 0.001），各分项也良好（r > 0.89，p < 0.001）。观察者量表总评分的变异系数为10.4%，患者量表为15.8%，表明一致性良好。
患者和观察者瘢痕评估量表是评估线状瘢痕的合适主观工具。
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