Institute for Medical and Biomedical Education, St George's University of London, London, SW17 0RE, United Kingdom.
Faculty of Medicine, Medical University of Sofia, Sofia, 1641, Bulgaria.
Chin J Traumatol. 2023 Sep;26(5):276-283. doi: 10.1016/j.cjtee.2023.02.001. Epub 2023 Feb 9.
Scar assessment tools can be utilized during the post-operative period to monitor scar progress. The primary aim of this systematic review was to evaluate current subjective scar assessment scales utilized in orthopaedic surgery. The secondary aim was to identify determinants of patients' satisfaction with their scars and evaluate current measurement scales.
The preferred reporting items for systematic reviews and meta-analyses checklist was followed. Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. There were no constraints based on language or publication status. A narrative synthesis provided a description and evaluation of scales utilized in orthopaedic surgery. Determinants of patient satisfaction were identified along with the scales used to measure satisfaction.
A total of 6059 records were screened in the initial search. Twenty-six articles satisfied the inclusion criteria, assessing 7130 patients. In the literature, six validated subjective scar scales were identified, including the Vancouver scar scale, patient and observer scar assessment scale, Manchester scar scale, Stony Brook scar evaluation scale, visual analogue scale, and Hollander wound evaluation scale. Studies utilizing these scales to evaluate scars following orthopaedic procedures did so successfully. These were total hip arthroplasty, total knee arthroplasty, and limb reconstruction. The scales demonstrated satisfactory validity. Functional outcomes such as restoration of movement ranked among patients' highest concerns. Scar cosmesis was found to be amongst patients' lowest priorities.
Subjective scar assessment scales identified in the literature were not designed specifically for orthopaedic surgery. However, these were able to appropriately assess scars in the studies identified in this review. Current evidence suggests the effect of scar cosmesis on patient satisfaction with orthopaedic procedures is limited.
疤痕评估工具可用于术后监测疤痕进展。本系统评价的主要目的是评估骨科手术中当前使用的主观疤痕评估量表。次要目的是确定患者对其疤痕满意度的决定因素，并评估当前的测量量表。
遵循系统评价和荟萃分析报告的首选项目清单。电子数据库、当前注册的研究、会议记录和纳入研究的参考文献均进行了搜索。没有基于语言或出版状态的限制。叙述性综合提供了对骨科手术中使用的量表的描述和评估。确定了患者满意度的决定因素以及用于测量满意度的量表。
在最初的搜索中筛选出了 6059 条记录。26 篇文章符合纳入标准，评估了 7130 名患者。在文献中，确定了 6 种经过验证的主观疤痕量表，包括温哥华疤痕量表、患者和观察者疤痕评估量表、曼彻斯特疤痕量表、石溪疤痕评估量表、视觉模拟量表和霍兰德伤口评估量表。这些量表成功地用于评估骨科手术后的疤痕。这些手术包括全髋关节置换术、全膝关节置换术和肢体重建术。这些量表表现出令人满意的有效性。功能结果（如运动的恢复）被列为患者最关心的问题之一。疤痕美容效果被发现是患者最不关心的问题之一。
文献中确定的主观疤痕评估量表并非专为骨科手术设计。然而，在本综述中确定的研究中，这些量表能够适当地评估疤痕。目前的证据表明，疤痕美容效果对骨科手术患者满意度的影响是有限的。
