Association of Dutch Burn Centres, Beverwijk, The Netherlands.
Burns. 2011 Jun;37(4):566-71. doi: 10.1016/j.burns.2011.02.004. Epub 2011 Mar 8.
Assessment of the take of split-skin graft and the rate of epithelialisation are important parameters in burn surgery. Such parameters are normally estimated by the clinician in a bedside procedure. This study investigates whether this subjective assessment is reliable for graft take and wound epithelialisation.
Observers involved in the field of burns (experienced, medium-experienced and inexperienced observers), and dermatologists specialized in the field of wound healing evaluated the percentage graft take and epithelialisation in 50 photographic skin-grafted burn wounds. Reliability was tested using the intraclass correlation coefficient (ICC).
Intra- and interobserver reliability of parameter graft take was highest within the experienced observers (ICC average > 0.91), followed by medium- and inexperienced observers (ICC average > 0.80 and ICC average > 0.68). Parameter epithelialisation showed the same pattern of intra- and interobserver ICC scores (experienced > medium > inexperienced). Interobserver ICC single scores of the experienced group were reasonable to good. Interobserver reliability of the dermatologists was similar to medium-experienced observers.
Our data show that one experienced observer can obtain adequate reliable results by means of a single assessment of graft take and epithelialisation. Furthermore, experience of the observer results in an increase of reliability.
评估游离皮片的成活率和上皮化率是烧伤外科中的重要参数。这些参数通常由临床医生在床边进行评估。本研究旨在探讨这种主观评估对于皮片成活率和创面上皮化的可靠性。
参与烧伤领域的观察者（有经验、中等经验和无经验的观察者）和专门研究创面愈合的皮肤科医生评估了 50 例摄影性皮肤移植烧伤创面的皮片成活率和上皮化率。使用组内相关系数（ICC）来测试可靠性。
参数皮片成活率的观察者内和观察者间可靠性在有经验的观察者中最高（ICC 平均值>0.91），其次是中等经验和无经验的观察者（ICC 平均值>0.80 和 ICC 平均值>0.68）。参数上皮化也表现出相同的观察者内和观察者间 ICC 评分模式（有经验者>中等经验者>无经验者）。经验丰富组的观察者间 ICC 单项评分是合理的。皮肤科医生的观察者间可靠性与中等经验观察者相似。
我们的数据表明，单个有经验的观察者可以通过单次评估皮片成活率和上皮化率获得足够可靠的结果。此外，观察者的经验会提高可靠性。
