Characterization strategies for the functional assessment of the cutaneous lesion

Rodrigues, Luís Monteiro; Roberto, Maria Angélica

doi:10.1016/j.burns.2006.03.022

Cited by 6 publications

(4 citation statements)

References 31 publications

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“…The method for measuring transcutaneous oxygen tension exploits the redox reactions that occur in a modified Clark electrode that measures the oxygen (tcpO 2 ) and carbon dioxide (tcpCO 2 ) tension on the surface of the skin. The tcpCO 2 is considered non-specific and highly dependent of external factors, whilst the tcpO 2 is a much more precise indicator of local perfusion [ 181 ]. This technique seems to have been recently abandoned from clinical practice.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of objective burn scar measurements

et al. 2016

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BackgroundProblematic 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.MethodsA 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.ResultsAfter 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.ConclusionsObjective 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.

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Section: Resultsmentioning

confidence: 99%

A systematic review of objective burn scar measurements

et al. 2016

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“…Adequate wound (tissue) perfusion is critical for collagen synthesis as low oxygen tension impairs wound healing (Hartmann et al , 1992). Laser Doppler flowmetry (LDF) is a non‐invasive procedure to measure cutaneous circulation (Rodrigues & Roberto, 2006; Rossi, Carpi, Galetta, Franzoni, & Santoro, 2006). If available, LDF should be used in conjunction with visual inspection and ultrasound scanning to improve interpretation of the healing progression in response to psychological stressors.…”

Section: Acute Woundsmentioning

confidence: 99%

The use of wound healing assessment methods in psychological studies: A review and recommendations

Koschwanez

Broadbent

2011

British Journal of Health Psychology

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Researchers need to consider several design-related issues when conducting studies into the effects of psychological stress on wound healing, including the study aims, type of wound, tissue type, setting, sample characteristics and accessibility, costs, timeframe, and facilities available. Researchers should consider combining multiple wound assessment methods to increase the reliability and validity of results and to further understand mechanisms that link stress and wound healing.

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“…Low technology BSOMs consist of simple, inexpensive, and noninvasive rating scales and include the Vancouver Scar Scale (VSS), 17 modifications to the VSS, 18 -20 numeric scales, [21][22][23][24] the Matching Assessment of Scars and Photographs, 11 and the Patient and Observer Scar Assessment Scale. 15 Many highly technical BSOMs have been described and include photography, 25 ultrasound, 16,26,27 elastometer, 28 extensometer, 29,30 tonometer, 31,32 pneumatonometer, 25,30 durameter/durometer, 25,33 cutometer, 16,34,35 laser Doppler, 14,25 biopsy, 25,36 threedimensional mould, 20 dermaspectrometer, 25,37 chromameter, 25,27,37 spectrocolorimeter, 38 infrared camera, 39 three-dimensional imaging, 13,40 oximetry, 39 and planimetry. 25 Although more objective than rating scales, most of these assessments are costly, timeconsuming, highly technological, inconvenient to use, and often nonportable, which make them clinically impractical.…”

mentioning

confidence: 99%

“…2,8 -10 A major problem in determining the effectiveness of costly scar management techniques, such as pressure garments, is the inability to measure the properties of the hypertrophic scar and the changes in those properties over time. 3,[11][12][13][14] To date, an objective burn scar outcome measure (BSOM) to determine scar maturation, monitor the effectiveness of pressure therapy, justify the use of pressure garments, and compare burn scar treatment methods does not exist. 3,11,[13][14][15][16] To improve the evaluation of hypertrophic scar, common definitions of the properties of hypertrophic scar must be developed and agreed upon, so that effective communication can occur between scar evaluators.…”

mentioning

confidence: 99%

Burn Therapists’ Opinion on the Application and Essential Characteristics of a Burn Scar Outcome Measure

Forbes-Duchart

Cooper

Nedelec

et al. 2009

Journal of Burn Care & Research

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Comprehensive burn rehabilitation requires the use of an appropriate burn scar outcome measure (BSOM). The literature reports many BSOMs; however, an objective, practical, inexpensive, valid, reliable, and responsive instrument eludes us. A problem in the development of such a measure is disagreement in which scar properties to include. The objective of this study was to determine the burn scar variables that therapists believe should be included in a BSOM. An Internet survey was administered to burn occupational and physical therapists. The response rate was 38.6% (105 surveys). Of the respondents, 38.1% use a BSOM; of those, 75% use the Vancouver Scar Scale. Reasons why respondents do not use a BSOM (61.9%) are because they are not familiar with available measures, have not found one that is clinically practical, or need more training. The majority (95%) believes that using a BSOM is important, and the following BSOM characteristics were reported as important: reliable, valid, quick, easy, and noninvasive. Respondents indicated that the following properties should be included in a BSOM: pliability (96.2%), vascularity (92.4%), height (87.6%), appearance (75.2%), skin breakdown (74.3%), itch (73.3%), surface texture (70.5%), pigmentation (68.6%), and pain (67.6%). This study suggests that using a BSOM is important despite its inconsistent use, and BSOM education may be valuable. The top three agreed-upon properties for inclusion are already incorporated into the most commonly used BSOM-the Vancouver Scar Scale-suggesting that modifications may be reasonable.

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Characterization strategies for the functional assessment of the cutaneous lesion

Cited by 6 publications

References 31 publications

A systematic review of objective burn scar measurements

A systematic review of objective burn scar measurements

The use of wound healing assessment methods in psychological studies: A review and recommendations

Burn Therapists’ Opinion on the Application and Essential Characteristics of a Burn Scar Outcome Measure

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