A review of scar assessment scales

Nguyen, Thao Thi Thu; Feldstein, Stephanie; Shumaker, Peter R.; Krakowski, Andrew C.

doi:10.12788/j.sder.2015.0125

Cited by 87 publications

(89 citation statements)

References 56 publications

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“…Clinicianrated scar severity and scar types may not necessarily correlate with the extent of a patient's psychosocial distress. 24 Rather, scar location, a patients' own subjective rating of scar severity, and the personality traits (eg, extraversion, optimism, hopeful) of the affected individual appear to best predict the psychological impact a scar may have. 25,26 Indirectly, the reaction of others to a scar may play a crucial role in the stigmatization or discrimination of the affected individual.…”

Section: Psychosocial Signs and Symptomsmentioning

confidence: 99%

Scar Management in the Pediatric and Adolescent Populations

Krakowski

Totri

Donelan³

et al. 2016

Pediatrics

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For most children and adolescents who have developed symptomatic scars, cosmetic concerns are only a portion of the motivation that drives them and their caregivers to obtain treatment. In addition to the potential for cosmetic disfigurement, scars may be associated with a number of physical comorbidities including hypertrichosis, dyshidrosis, tenderness/pain, pruritus, dysesthesias, and functional impairments such as contractures, all of which may be compounded by psychosocial factors. Although a plethora of options for treating scars exists, specific management guidelines for the pediatric and adolescent populations do not, and evidence must be extrapolated from adult studies. New modalities such as the scar team approach, autologous fat transfer, and ablative fractional laser resurfacing suggest a promising future for children who suffer symptomatically from their scars. In this state-of-the-art review, we summarize cutting-edge scar treatment strategies as they relate to the pediatric and adolescent populations.

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Section: Psychosocial Signs and Symptomsmentioning

confidence: 99%

Scar Management in the Pediatric and Adolescent Populations

Krakowski

Totri

Donelan³

et al. 2016

Pediatrics

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“…Moreover, a common skin tumour in horses, the equine sarcoid, which is clinically and histopathologically similar to DFSP, is linked to bovine papillomavirus (BPV) type 1 or 2 infection. 1 Additionally, lymphoproliferative disorders involving chromosomal translocations have been related to viruses such as the Epstein-Barr virus (EBV) in Burkitt lymphoma. Using a high throughput sequencing (HTS) method of cell RNAs, the aim of this work was to evaluate the presence of viral transcripts in DFSP, to be eventually related to the genomic instability.…”

Section: Conflicts Of Interest: None To Declarementioning

confidence: 99%

“…Dear Editor , Several validated outcome measures exist for the assessment of postoperative linear scars, but all are subjective in nature . These measures suffer from inter‐ and intrarater discrepancies depending on observer expertise or inherent biases .…”

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confidence: 99%

Development and initial validation of the trace‐to‐tape method: an objective outcome measure for linear postoperative scars

et al. 2019

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“…178 A gold standard scar scale does not currently exist, although, ideally, such a scale should address cosmetic, functional and psychological sequelae. 179 Outcomes which involve parental evaluation, in addition to clinician evaluation, should also be considered for certain assessments, including scarring. The reliability and validity of outcome measures would need to be established for use in neonatal populations.…”

Section: Treatments Populations and Outcomesmentioning

confidence: 99%

Treatment of extravasation injuries in infants and young children: a scoping review and survey

Corbett

Marshall

Harden

et al. 2018

Health Technol Assess

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BackgroundExtravasation injuries are caused by unintended leakages of fluids or medicines from intravenous lines, but there is no consensus on the best treatment approaches.ObjectivesTo identify which treatments may be best for treating extravasation injuries in infants and young children.DesignScoping review and survey of practice.PopulationChildren aged < 18 years with extravasation injuries and NHS staff who treat children with extravasation injuries.InterventionsAny treatment for extravasation injury.Main outcome measuresWound healing time, infection, pain, scarring, functional impairment, requirement for surgery.Data sourcesTwelve database searches were carried out in February 2017 without date restrictions, including MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus and EMBASE (Excerpta Medica dataBASE).MethodsScoping review – studies were screened in duplicate. Data were extracted by one researcher and checked by another. Studies were grouped by design, and then by intervention, with details summarised narratively and in tables. The survey questionnaire was distributed to NHS staff at neonatal units, paediatric intensive care units and principal oncology/haematology units. Summary results were presented narratively and in tables and figures.ResultsThe evidence identified in the scoping review mostly comprised small, retrospective, uncontrolled group studies or case reports. The studies covered a wide range of interventions including conservative management approaches, saline flush-out techniques (with or without prior hyaluronidase), hyaluronidase (without flush-out), artificial skin treatments, debridement and plastic surgery. Few studies graded injury severity and the results sections and outcomes reported in most studies were limited. There was heterogeneity across study populations in age, types of infusate, injury severity, location of injury and the time gaps between injury identification and subsequent treatment. Some of the better evidence related to studies of flush-out techniques. The NHS survey yielded 63 responses from hospital units across the UK. Results indicated that, although most units had a written protocol or guideline for treating extravasation injuries, only one-third of documents included a staging system for grading injury severity. In neonatal units, parenteral nutrition caused most extravasation injuries. In principal oncology/haematology units, most injuries were due to vesicant chemotherapies. The most frequently used interventions were elevation of the affected area and analgesics. Warm or cold compresses were rarely used. Saline flush-out treatments, either with or without hyaluronidase, were regularly used in about half of all neonatal units. Most responders thought a randomised controlled trial might be a viable future research design, though opinions varied greatly by setting.LimitationsPaucity of good-quality studies.ConclusionsThere is uncertainty about which treatments are most promising, particularly with respect to treating earlier-stage injuries. Saline flush-out techniques and conservative management approaches are commonly used and may be suitable for evaluation in trials.Future workConventional randomised trials may be difficult to perform, although a randomised registry trial may be an appropriate alternative.FundingThe National Institute for Health Research Health Technology Assessment programme.

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A review of scar assessment scales

Cited by 87 publications

References 56 publications

Scar Management in the Pediatric and Adolescent Populations

Scar Management in the Pediatric and Adolescent Populations

Development and initial validation of the trace‐to‐tape method: an objective outcome measure for linear postoperative scars

Treatment of extravasation injuries in infants and young children: a scoping review and survey

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