The Patient and Observer Scar Assessment Scale: A Reliable and Feasible Tool for Scar Evaluation

Abstract

At present, various scar assessment scales are available, but not one has been shown to be reliable, consistent, feasible, and valid at the same time. Furthermore, the existing scar assessment scales appear to attach little weight to the opinion of the patient. The newly developed Patient and Observer Scar Assessment Scale consists of two numeric scales: the Patient Scar Assessment Scale (patient scale) and the Observer Scar Assessment Scale (observer scale). The patient and observer scales have to be completed by the patient and the observer, respectively. The patient scale's consistency and the observer scale's consistency, reliability, and feasibility were tested. For the Vancouver Scar Scale, which is the most frequently used scar assessment scale at present, the same statistical measurements were examined and the results of the observer scale and the Vancouver scale were compared. The concurrent validity of the observer scale was tested with a correlation to the Vancouver scale. Furthermore, the authors examined which specific characteristics significantly influence the general opinion of the patient and the observers on the scar areas. Four independent observers have each used the observer scale and the Vancouver scale to assess 49 burn scar areas of 3 x 3 cm belonging to 20 different patients. Subsequently, the patients completed the patient scale for their scar areas. The (internal) consistency of both the patient and the observer scales was acceptable (Cronbach's alpha, 0.76 and 0.69, respectively), whereas the consistency of the Vancouver scale appeared not to be acceptable (alpha, 0.49). The reliability of the observer scale completed by a single observer was acceptable (r = 0.73). The reliability of the Vancouver scale completed by a single observer was lower (r = 0.69). The observer scale showed better agreement than the Vancouver scale because the coefficient of variation was lower (18 percent and 22 percent, respectively). The concurrent validity of the observer scale in relation to the Vancouver scale is high (r = 0.89, p < 0.001). Linear regression of the general opinions on scars of the observer and the patient showed that the observer's opinion is influenced by vascularization, thickness, pigmentation, and relief, whereas the patient's opinion is mainly influenced by itching and the thickness of the scar. Such an impact of itching and thickness of the scar on the patient's opinion is an important and novel finding. The Patient and Observer Scar Assessment Scale offers a suitable, reliable, and complete scar evaluation tool.

A Comparative Study of Stapled Vs Subcuticular Vs Simple Interrupted Closure of Inguinal Hernia Incision

“…Scar assessment scale wasPatient and Observer Scar Assessment Scale (POSAS).The observer scale of the POSAS consists of six items All items are scored on a scale ranging from 1 ('like normal skin') to 10 ('worst scar imaginable'). Both total and overall opinion was studied.Draaijers LJ, Tempelman FR, BotmanYA (18) showed that POSASScale offers a suitable, reliable, and complete scar evaluation tool. Both Total and Overall POSAS score was significantly less (p=0.002 & p=0.003 respectively) in subcuticular group.Overall best cosmetic appearance of skin was with subcuticular followed by simple interrupted and comparatively worst with stapler.…”

Patient perception, satisfaction and cosmetic results of surgical atrial septal defect closure: Minithoracotomy versus sternotomy

“…Nevertheless, many studies have reported increased patient gratification with the overall appearance of their scars when thoracotomies were used to close ASDs, although these findings have not been supported by any patient surveys or interviews. [25] Draaijers et al [26] reported that the POSAS is a more suitable, reliable, and complete scar evaluation tool than the VSS, but we found that the VSS and POSAS yielded similar wound characteristics and produced comparable results. However, the incidence of unpleasant hypertrophic scar formation in our study was higher in the patients with MS.…”

Avaliação da qualidade de cicatrizes em mamoplastia de aumento por via submamária e transareolomamilar: um estudo longitudinal prospectivo

“…Para a analgesia pós-operatória, utilizou-se Dipirona 8 mg por kg de peso, endovenosa (EV), de 6 em 6 h e Tenoxican 0,3 mg por kg de peso, EV, de 12 em 12 h e, se necessário, Quando as pacientes retornaram para a revisão de 12 meses de pós-operatório foi aplicada a Escala Paciente e Observador de Avaliação da Cicatriz (EPOAC) 7 . Esta escala consiste em duas escalas numéricas: a preenchida pelo paciente, que contém seis itens (dor, prurido, coloração, endurecimento, espessura e irregularidade) e a do observador, que contém cinco itens (vascularização, espessura, relevo, maleabilidade e pigmentação).…”

“…A contagem 10 reflete a pior cicatriz ou sensação imaginável, já a 1 reflete uma pele normal. As contagens totais mais baixas, 6 e 5, respectivamente, refletem a pele normal, enquanto que contagens totais mais altas, 60 e 50, respectivamente, refletem a pior cicatriz imaginável 7,8 . O cálculo do tamanho da amostra foi baseado em α = 0,05 com um poder de estimativa de 0,80 utilizando o programa de computador PS: Power and Sample Size (Vanderbilt University Medical Center, Nashville, EUA).…”