Singer Adam J, Arora Blavantray, Dagum Alexander, Valentine Sharon, Hollander Judd E
Stony Brook, N.Y.; and Philadelphia, Pa. From the Departments of Emergency Medicine and Plastic Surgery, Stony Brook University, and the Department of Emergency Medicine, University of Pennsylvania.
Plast Reconstr Surg. 2007 Dec;120(7):1892-1897. doi: 10.1097/01.prs.0000287275.15511.10.
The authors previously developed a six-item ordinal wound evaluation scale to measure the short-term cosmetic outcome of wounds 1 week after injury. Although it was never intended to measure long-term outcomes, it has been used to assess scars 3 to 12 months after injury. The authors developed and validated a scar evaluation scale specifically aimed at measuring the long-term appearance of scars.
Two plastic surgeons and one emergency physician, blinded to each other's assessments, viewed photographs of 50 scars resulting from lacerations or surgical incisions. Scars were assigned 0 or 1 point each for the presence or absence of the following: width greater than 2 mm, elevation or depression, discoloration, suture or staple marks, and overall poor appearance. A total cosmetic score was then calculated by adding the individual scores on each of the five categories ranging from 0 (worst) to 5 (best). Scars were also scored on a validated 100-mm visual analogue scale marked "worst scar" and "best scar" at the low and high ends, respectively. Pairwise interobserver agreement was calculated.
Interobserver agreement for the total scores on the scar evaluation scale was 0.73, 0.75, and 0.85 (p < 0.001 for all). Interobserver correlations on the visual analogue scale were 0.83, 0.86, and 0.87 (p < 0.001 for all). Correlations between the total scar evaluation scale and visual analogue scale scores were 0.75, 0.86, and 0.92. Visual analogue scale scores were significantly higher as scar evaluation scale scores increased (analysis of variance, p < 0.001).
The authors describe a new long-term scar evaluation scale that is highly reliable and correlated with the cosmetic visual analogue scale, suggesting construct validity.
作者之前开发了一种六项序贯伤口评估量表，用于测量受伤1周后伤口的短期美容效果。尽管该量表并非用于测量长期结果，但已被用于评估受伤3至12个月后的瘢痕。作者开发并验证了一种专门用于测量瘢痕长期外观的瘢痕评估量表。
两名整形外科医生和一名急诊医生在彼此不知情的情况下查看了50例因撕裂伤或手术切口形成的瘢痕照片。根据以下情况的有无，每条瘢痕给予0分或1分：宽度大于2毫米、隆起或凹陷、色素沉着、缝线或钉痕以及整体外观不佳。然后通过将五个类别中每个类别的个体得分相加来计算总美容评分，范围从0（最差）到5（最佳）。瘢痕还在一个经过验证的100毫米视觉模拟量表上进行评分，该量表在低端和高端分别标记为“最差瘢痕”和“最佳瘢痕”。计算观察者间的两两一致性。
瘢痕评估量表总分的观察者间一致性分别为0.73、0.75和0.85（所有p值均<0.001）。视觉模拟量表上的观察者间相关性分别为0.83、0.86和0.87（所有p值均<0.001）。瘢痕评估量表总分与视觉模拟量表得分之间的相关性分别为0.75、0.86和0.92。随着瘢痕评估量表得分增加，视觉模拟量表得分显著升高（方差分析，p<0.001）。
作者描述了一种新的长期瘢痕评估量表，该量表高度可靠，且与美容视觉模拟量表相关，提示有结构效度。
