Scar Perception: A Comparison of African American and White Self-identified Patients

Garg, Stuti; Hassan, Abbas M.; Koko, Deima; Varghese, Jeffrey; Ellis, Marco F.; Kim, John Y.S.; Galiano, Robert D.

doi:10.1097/gox.0000000000004345

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…In the United States, 17% of the population is of Fitzpatrick's IV-VI and given the susceptibility of darker-skinned individuals to poorer scarring outcomes and QOL, and it is critical to include patients of colour in the very assessment tools that will be used to determine their scar prognosis. 26,51,52,59,60 Inclusion of patients of colour in scar assessment development will improve assessment of scar pathology in diverse skin types and better inform decision-making regarding scar care. Finally, given the lack of inclusion of dark-skinned individuals in the development of scar assessment tools, it is very difficult to offer sound recommendations in terms of which scales would be best for this particular patient population.…”

Section: Discussionmentioning

confidence: 99%

“…The percentage of dark‐skinned patients was as much as 17% and as little as 4.5%. In the United States, 17% of the population is of Fitzpatrick's IV–VI and given the susceptibility of darker‐skinned individuals to poorer scarring outcomes and QOL, and it is critical to include patients of colour in the very assessment tools that will be used to determine their scar prognosis 26,51,52,59,60 . Inclusion of patients of colour in scar assessment development will improve assessment of scar pathology in diverse skin types and better inform decision‐making regarding scar care.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating skin colour diversity in the validation of scar assessment tools

Garg,

Williams,

Taritsa

et al. 2023

Wound Repair Regeneration

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Across scar studies, there is a lack of dark‐skinned individuals, who have a predisposition for keloid formation, altered pigmentation, and poorer quality‐of‐life. There is a need for patients‐of‐color to be included in scar scale development and validation. In this study, we evaluate the racial diversity of patients included in the validation of scar assessment scales. A systematic review was conducted for articles reporting on the validation of a scar assessment tool. Racial, ethnic, and Fitzpatrick skin type(FST) data was extracted. Fifteen scar scale validation studies were included. Nine of the studies did not mention FST, race, or ethnicity of the patients. Two of the studies that reported FST or race information only included White patients or included no FST V/VI patients: MAPS and UNC4P. Only four studies included non‐white patients or dark‐skinned patients in the validation of their scar scale: the modified Vancouver Scar Scale, Modified POSAS, Acne QOL, and SCAR‐Q scales. The patients included in the modified VSS validation were 7 and 13% FST V/VI, 14% African in the modified POSAS, and 4.5% FST V/VI in the SCAR‐Q. We highlight the severe lack of diversity in scar scale validation, with only 4 out of 15 studies including dark‐skinned patients. Given the susceptibility of darker‐skinned individuals to have poorer scarring outcomes, it is critical to include patients‐of‐color in the very assessment tools that determine their scar prognosis. Inclusion of patients‐of‐color in scar scale development will improve scar assessment and clinical decision‐making.This article is protected by copyright. All rights reserved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluating skin colour diversity in the validation of scar assessment tools

Garg,

Williams,

Taritsa

et al. 2023

Wound Repair Regeneration

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“…The results underestimated research in sex-affirming surgery and the disparities experienced by transgender and gender diverse (TGD) people 3 . Other studies draw damaging conclusions between race and health outcomes, implying a genetic predisposition to certain conditions such as the coronavirus disease 2019 (COVID-19) and surgical site scarring where systems level and social factors are undoubtedly greater influences 4,5 . The conclusions are superficial and offer surgeons limited actionable recommendations.…”

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confidence: 94%

“…3 Other studies draw damaging conclusions between race and health outcomes, implying a genetic predisposition to certain conditions such as the coronavirus disease 2019 (COVID-19) and surgical site scarring where systems level and social factors are undoubtedly greater influences. 4,5 The conclusions are superficial and offer surgeons limited actionable recommendations. Moreover, authorship often fails to include health equity scholars or individuals representing the communities under investigation.Historically, the field of health equity was composed of individuals from backgrounds most harmed by discrimination and systemic inequity.…”

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confidence: 99%

Combating Health Equity Tourism in Plastic Surgery

Das

Drolet

2023

Ann Plast Surg

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D espite growing efforts to improve health care access, individuals from marginalized communities continue to face the effects of long-standing structural discrimination and inequity. The current sociopolitical climate, shaped by acts of racism such as the murder of George Floyd and legislative assaults on the rights of lesbian, gay, bisexual, transgender, and other sexual and gender diverse (LGBTQ+) identities, highlights the need to examine health care access for marginalized groups. It is estimated that health disparities driven by racial inequity alone will cost $50 billion annually by 2050. 1 This estimate does not account for the costs of disparities for LGBTQ+ persons and those with intersecting identities. Health equity research seeks to identify and address the mechanisms underlying disparities for marginalized populations. In response to the growing recognition of health care disparities, the National Institutes of Health has allocated more funds toward health equity research, and journals have increased calls for and publication of health equity-related work. These initiatives have similarly touched the plastic surgery community, promoting awareness for disparities in access to plastic surgery and outcomes.Importantly, health equity scholars and surgeon advocates with expertise in health equity and life experiences motivating them to pursue health disparities research should benefit from increasing financial and institutional support. However, their efforts and reputation are being usurped by surgeons and researchers, often well-resourced, without health equity training or exposure to diverse populations. This phenomenon is called "health equity tourism." A surgeon's identity is an important determinant of the kind of research they produce because an authentic clinical or personal interest in the subject matter under investigation strengthens the impact of the study's conclusions. For some of these newcomers, their motivations may be short term and superficial, seeking to enhance their research productivity and academic career without authentically engaging in discussions about advancing equity for the communities they publish about or serve. Others may have been moved by recent public events and are searching for an outlet to use their skills and resources to help.Unfortunately, the rapid colonization of the health equity space has affronted plastic surgeons from marginalized communities who have not only been investigating health disparities and advocating for change in their specialties for years but also share experiences of marginalization with the subjects of their research. Their efforts have pushed national organizations such as the Accreditation Council for Graduate Medical Education to mandate that diversity, equity, and inclusion become a priority for academic institutions and training programs. However, numerous scholars of color have come forward after studies conducted by all White, cisgender authors redocumenting known health disparities were published in high-impact journals that initia...

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