DermaLab Combo®色素沉着和血管状况测量在烧伤瘢痕评估中的解读：一项探索性分析。
Interpretation of the DermaLab Combo® pigmentation and vascularity measurements in burn scar assessment: an exploratory analysis.
作者信息
Gankande T U, Duke J M, Wood F M, Wallace H J
机构信息
Burn Injury Research Unit, Burn Injury Research Unit, School of Surgery, M318, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia.
出版信息
Burns. 2015 Sep;41(6):1176-85. doi: 10.1016/j.burns.2015.01.012. Epub 2015 Feb 19.
BACKGROUND
The DermaLab Combo® measures pigmentation and vascularity of a burn scar more reliably than the modified Vancouver Scar Scale (mVSS). This study aims to examine how the DermaLab Combo® continuous measurements of pigmentation and vascularity of burns scars relate to the mVSS, a standard clinical scar assessment method; and secondly, to obtain evidence to support the concurrent validity of DermaLab Combo® measurements for pigmentation and vascularity.
METHOD
Scar assessments were performed on an index burn scar of 100 subjects using two methods: the mVSS (two raters) and the DermaLab Combo® device (one rater). Using the DermaLab Combo®, measurements of pigmentation and vascularity for the index scar and an adjacent normal skin site were obtained. Indices were generated to represent the scar pigmentation (melanin index, MI%) and scar vascularity (erythema index, EI%) relative to the patient's matched normal skin. Exploratory univariate and bivariate analyses were conducted and the concordance of classification by mVSS score using DermaLab® cut-off values was assessed.
RESULTS
For pigmentation, the results suggest a 80% classification concordance for the DermaLab Combo® MI% values into mVSS pigmentation categories (hypopigmentation, normal pigmentation and hyperpigmentation) using two predictors (MI% and EI%) and visually fitted discriminant axis cut-offs. Due to the high degree of overlap of EI% values between the vascularity categories, meaningful classification of EI% values using the mVSS was not possible.
CONCLUSION
Quantifying percentage changes in melanin and erythema relative to matched normal skin improved understanding of the DermaLab Combo® pigmentation and vascularity measurements. The DermaLab Combo® pigmentation MI% values were able to be classified into pigmentation categories of the mVSS, and pigmentation classification concordance was further improved with consideration of the scar's DermaLab Combo® vascularity EI% values. The DermaLab Combo® is an objective tool; however, while the measurement provides continuous numerical data that may be useful for identifying change over time in clinical scar monitoring of pigmentation and vascularity, further work will be useful to understand the DermaLab Combo® measurements to optimise the interpretation of these data.
背景
与改良温哥华瘢痕量表（mVSS）相比，DermaLab Combo® 能更可靠地测量烧伤瘢痕的色素沉着和血管分布情况。本研究旨在探讨 DermaLab Combo® 对烧伤瘢痕色素沉着和血管分布的连续测量结果与标准临床瘢痕评估方法 mVSS 之间的关系；其次，获取证据以支持 DermaLab Combo® 对色素沉着和血管分布测量的同时效度。
方法
采用两种方法对 100 名受试者的一处烧伤瘢痕进行瘢痕评估：mVSS（两名评估者）和 DermaLab Combo® 设备（一名评估者）。使用 DermaLab Combo® 获取该瘢痕及相邻正常皮肤部位的色素沉着和血管分布测量值。生成指数以表示相对于患者匹配正常皮肤的瘢痕色素沉着（黑色素指数，MI%）和瘢痕血管分布（红斑指数，EI%）。进行探索性单变量和双变量分析，并使用 DermaLab® 临界值评估根据 mVSS 评分进行分类的一致性。
结果
对于色素沉着，结果表明，使用两个预测因子（MI% 和 EI%）以及视觉拟合判别轴临界值，DermaLab Combo® 的 MI% 值在 mVSS 色素沉着类别（色素减退、色素正常和色素沉着过度）中的分类一致性为 80%。由于血管分布类别之间 EI% 值的重叠程度较高，因此无法使用 mVSS 对 EI% 值进行有意义的分类。
结论
相对于匹配的正常皮肤，量化黑色素和红斑的百分比变化有助于更好地理解 DermaLab Combo® 的色素沉着和血管分布测量结果。DermaLab Combo® 的色素沉着 MI% 值能够被分类到 mVSS 的色素沉着类别中，并且在考虑瘢痕的 DermaLab Combo® 血管分布 EI% 值后，色素沉着分类一致性进一步提高。DermaLab Combo® 是一种客观工具；然而，虽然该测量提供了连续的数值数据，可能有助于在临床瘢痕色素沉着和血管分布监测中识别随时间的变化，但进一步的研究将有助于理解 DermaLab Combo® 的测量结果，以优化对这些数据的解释。
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