客观烧伤瘢痕测量的系统评价。

BACKGROUND: Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor. At present, there are few treatments available in the clinic to control adverse scarring, but experimental pharmacological anti-scarring strategies are now beginning to emerge. Their comparative success must be based on objective measurements of scarring, yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients. However, several techniques and devices are being introduced that allow objective analysis of the burn scar. The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies. METHODS: A systematic literature search was done using the Web of Science, PubMed and Cochrane databases. The identified devices were then classified and grouped according to the parameters they measured. The tools were then compared and assessed in terms of inter- and intra-rater reproducibility, ease of use and cost. RESULTS: After duplicates were removed, 5062 articles were obtained in the search. After further screening, 157 articles which utilised objective burn scar measurement systems or tools were obtained. The scar measurement devices can be broadly classified into those measuring colour, metric variables, texture, biomechanical properties and pathophysiological disturbances. CONCLUSIONS: Objective scar measurement tools allow the accurate and reproducible evaluation of scars, which is important for both clinical and scientific use. However, studies to evaluate their relative performance and merits of these tools are scarce, and there remain factors, such as itch and pain, which cannot be measured objectively. On reviewing the available evidence, a panel of devices for objective scar measurement is recommended consisting of the 3D cameras (Eykona/Lifeviz/Vectra H1) for surface area and volume, DSM II colorimeter for colour, Dermascan high-frequency ultrasound for scar thickness and Cutometer for skin elasticity and pliability.

背景：在烧伤治疗中，问题性瘢痕仍然是一个具有挑战性的方面，会显著影响烧伤幸存者的生活质量。目前，临床上可用于控制不良瘢痕的治疗方法很少，但实验性的药理学抗瘢痕策略现在开始出现。它们的比较成功必须基于瘢痕的客观测量，但目前对瘢痕的临床评估没有系统地进行，主要是基于对患者的主观评估。然而，一些技术和设备正在被引入，以允许对烧伤瘢痕进行客观分析。本文旨在评估目前可用的各种客观测量工具，并推荐一个适合用于抗瘢痕治疗临床试验的有用工具包。

方法：使用 Web of Science、PubMed 和 Cochrane 数据库进行了系统的文献检索。然后根据所测量的参数对识别出的设备进行分类和分组。然后比较和评估工具的组内和组间可重复性、易用性和成本。

结果：在去除重复项后，搜索中获得了 5062 篇文章。进一步筛选后，获得了 157 篇使用客观烧伤瘢痕测量系统或工具的文章。瘢痕测量设备可大致分为测量颜色、度量变量、纹理、生物力学特性和病理生理紊乱的设备。

结论：客观瘢痕测量工具可准确、可重复地评估瘢痕，这对临床和科学应用都很重要。然而，评估这些工具的相对性能和优点的研究很少，而且仍然存在一些因素，如瘙痒和疼痛，无法进行客观测量。在回顾现有证据后，推荐使用一组客观瘢痕测量设备，包括用于表面积和体积的 3D 相机（Eykona/Lifeviz/Vectra H1）、用于颜色的 DSM II 比色计、用于瘢痕厚度的 Dermascan 高频超声和用于皮肤弹性和柔韧性的 Cutometer。