Carrière Michelle E, Kwa Kelly A A, de Haas Louise E M, Pijpe Anouk, Tyack Zephanie, Ket Johannes C F, van Zuijlen Paul P M, de Vet Henrica C W, Mokkink Lidwine B
Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, Noord-Holland, the Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
Plast Reconstr Surg Glob Open. 2019 Sep 30;7(9):e2424. doi: 10.1097/GOX.0000000000002424. eCollection 2019 Sep.
Measurements of scar quality are essential to evaluate the effectiveness of scar treatments and to monitor scars. A large number of scar scales and measurement devices have been developed, which makes instrument selection challenging. The aim of this study was to provide an overview of the content (ie, included items) of all outcome measurement instruments that measure scar quality in different types of scars (burn, surgical, keloid, and necrotizing fasciitis), and the frequency at which the instruments and included items are used.
A systematic search was performed in PubMed and Embase.com up to October 31, 2018. All original studies reporting on instruments that measured at least 1 characteristic of scar quality were included and the instrument's content was extracted.
We included 440 studies for data extraction. Included instruments (N = 909) were clinician-reported scales (41%), measurement devices (30%), patient-reported scales (26%), and combined clinician- and patient-reported scales (3%). The Observer scale of the Patient and Observer Scar Assessment Scale, the Cutometer, the Patient Scale of the Patient and Observer Scar Assessment Scale, and the modified Vancouver Scar Scale were the most often used instrument in each of these categories, respectively. The most frequent assessed items were thickness, vascularity, pigmentation, pliability, pain, and itch.
The results of this study lay the foundation for our future research, which includes an international Delphi study among many scar experts, and an international focus group study among scar patients, aiming to elucidate how scar quality must be defined and measured from both professional and patient perspectives.
瘢痕质量的测量对于评估瘢痕治疗效果和监测瘢痕至关重要。已经开发了大量的瘢痕量表和测量设备，这使得仪器选择具有挑战性。本研究的目的是概述所有测量不同类型瘢痕（烧伤、手术、瘢痕疙瘩和坏死性筋膜炎）瘢痕质量的结局测量工具的内容（即包含的项目），以及这些工具和包含项目的使用频率。
截至2018年10月31日，在PubMed和Embase.com上进行了系统检索。纳入所有报告测量至少1个瘢痕质量特征的工具的原始研究，并提取工具的内容。
我们纳入了440项研究进行数据提取。纳入的工具（N = 909）包括临床医生报告的量表（41%）、测量设备（30%）、患者报告的量表（26%）以及临床医生和患者联合报告的量表（3%）。患者和观察者瘢痕评估量表的观察者量表、皮肤弹性仪、患者和观察者瘢痕评估量表的患者量表以及改良温哥华瘢痕量表分别是这些类别中最常用的工具。最常评估的项目是厚度、血管分布、色素沉着、柔韧性、疼痛和瘙痒。
本研究结果为我们未来的研究奠定了基础，未来研究包括在众多瘢痕专家中开展的国际德尔菲研究，以及在瘢痕患者中开展的国际焦点小组研究，旨在从专业人员和患者的角度阐明瘢痕质量应如何定义和测量。
