Forbes-Duchart Lisa, Cooper Juliette, Nedelec Bernadette, Ross Lonny, Quanbury Arthur
Department of Occupational Therapy, Winnipeg Health Sciences Centre, Winnipeg, Manitoba, Canada.
J Burn Care Res. 2009 Sep-Oct;30(5):792-800. doi: 10.1097/BCR.0b013e3181b47cc2.
Comprehensive burn rehabilitation requires the use of an appropriate burn scar outcome measure (BSOM). The literature reports many BSOMs; however, an objective, practical, inexpensive, valid, reliable, and responsive instrument eludes us. A problem in the development of such a measure is disagreement in which scar properties to include. The objective of this study was to determine the burn scar variables that therapists believe should be included in a BSOM. An Internet survey was administered to burn occupational and physical therapists. The response rate was 38.6% (105 surveys). Of the respondents, 38.1% use a BSOM; of those, 75% use the Vancouver Scar Scale. Reasons why respondents do not use a BSOM (61.9%) are because they are not familiar with available measures, have not found one that is clinically practical, or need more training. The majority (95%) believes that using a BSOM is important, and the following BSOM characteristics were reported as important: reliable, valid, quick, easy, and noninvasive. Respondents indicated that the following properties should be included in a BSOM: pliability (96.2%), vascularity (92.4%), height (87.6%), appearance (75.2%), skin breakdown (74.3%), itch (73.3%), surface texture (70.5%), pigmentation (68.6%), and pain (67.6%). This study suggests that using a BSOM is important despite its inconsistent use, and BSOM education may be valuable. The top three agreed-upon properties for inclusion are already incorporated into the most commonly used BSOM-the Vancouver Scar Scale-suggesting that modifications may be reasonable.
全面的烧伤康复需要使用合适的烧伤瘢痕结局测量工具(BSOM)。文献报道了许多BSOM;然而,我们仍未找到一种客观、实用、廉价、有效、可靠且灵敏的工具。开发此类测量工具的一个问题在于对于应纳入哪些瘢痕特性存在分歧。本研究的目的是确定治疗师认为应纳入BSOM的烧伤瘢痕变量。对烧伤职业治疗师和物理治疗师进行了一项网络调查。回复率为38.6%(105份调查问卷)。在受访者中,38.1%使用BSOM;其中,75%使用温哥华瘢痕量表。受访者不使用BSOM的原因(61.9%)是他们不熟悉现有的测量工具,未找到临床实用的工具,或者需要更多培训。大多数(95%)认为使用BSOM很重要,并且以下BSOM特性被报告为重要:可靠、有效、快速、简便且无创。受访者指出,BSOM应纳入以下特性:柔韧性(96.2%)、血管分布(92.4%)、高度(87.6%)、外观(75.2%)、皮肤破损(74.3%)、瘙痒(73.3%)、表面质地(70.5%)、色素沉着(68.6%)和疼痛(67.6%)。本研究表明,尽管BSOM的使用并不一致,但使用它很重要,并且BSOM教育可能有价值。最常被认可应纳入的前三个特性已被纳入最常用的BSOM——温哥华瘢痕量表——这表明进行修改可能是合理的。