Lebanon, N.H. From the Section of Plastic Surgery and the Dartmouth-Hitchcock Leadership Preventive Medicine Residency Program, Dartmouth Hitchcock Medical Center.
Plast Reconstr Surg. 2009 Nov;124(5):1513-1519. doi: 10.1097/PRS.0b013e3181b9898e.
Existing scar evaluation tools are based on verbal descriptions and used primarily for burn scar assessment. To evaluate linear scars, the authors developed a new tool called the visual assessment of linear scars. This study was designed to determine whether patients and surgeons rated scars similarly and to test the intrarater and interrater reliability of the surgeons' ratings.
At 6 months postoperatively, 51 patients used the visual assessment of linear scars tool to rate each of their own surgical scars (two scars for abdominal; six scars for breast), and two surgeons used the visual assessment of linear scars tool to rate the patients' scar photographs. A post hoc two-sample t test was used to determine whether the raters' scar means were significantly different from each other. Spearman correlation was used to determine the intrarater and interrater reliability.
There was no difference in the mean scar ratings between the surgeons; however, both surgeons had significantly higher mean ratings than the patients (a higher score is a worse-appearing scar). Intrarater reliability for the surgeons was large (rho > 0.5) and interrater reliability between the surgeons was also large (rho = 0.53) but borderline.
The visual assessment of linear scars tool was developed to create a simple, straightforward method of assessing the overall appearance of the postsurgical linear scar, keeping in mind that the patient's perspective might differ from that of a surgeon or researcher. Both patients and surgeons found the ratings easy to perform, and the results showed that patients might rate their scars' appearance more favorably than the surgeons. The visual assessment of linear scars is a reliable tool with two plastic surgeons' rating of repeated photographs.
现有的疤痕评估工具基于口头描述，主要用于评估烧伤疤痕。为了评估线性疤痕，作者开发了一种新的工具，称为线性疤痕视觉评估。本研究旨在确定患者和外科医生是否对疤痕的评价相似，并测试外科医生评分的内部和外部可靠性。
在术后 6 个月，51 名患者使用线性疤痕视觉评估工具对自己的每一个手术疤痕（腹部两个疤痕；乳房六个疤痕）进行评分，两名外科医生使用线性疤痕视觉评估工具对患者的疤痕照片进行评分。使用事后两样本 t 检验确定评分者的疤痕平均值是否存在显著差异。使用 Spearman 相关系数来确定内部和外部评分者的可靠性。
外科医生之间的疤痕平均评分没有差异；然而，两名外科医生的平均评分均明显高于患者（评分越高，疤痕外观越差）。外科医生的内部评分可靠性较大（rho > 0.5），外科医生之间的外部评分可靠性也较大（rho = 0.53）但接近临界值。
线性疤痕视觉评估工具的开发是为了创建一种简单、直接的方法来评估术后线性疤痕的整体外观，同时要考虑到患者的观点可能与外科医生或研究人员不同。患者和外科医生都发现评分很容易进行，结果表明患者可能会对自己的疤痕外观评价更有利。线性疤痕视觉评估是一种可靠的工具，两名整形外科医生对重复照片的评分。
