The Patient-Reported Impact of Scars Measure: Development and Validation

Brown, Benjamin; McKenna, Stephen P.; Solomon, M; Wilburn, Jeanette; McGrouther, Duncan Angus; Bayat, Ardeshir

doi:10.1097/prs.0b013e3181d4fd89

Cited by 57 publications

(44 citation statements)

References 41 publications

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“…Secondary searching identified 2 additional articles describing and/or using the 4 scar-specific PRO instruments. The four scar-specific PRO instruments (see Table 2) were the Patient and Observer Scar Assessment Scale (POSAS) [13], Bock Quality of Life Questionnaire for Patients with Keloid and Hypertrophic Scarring (Bock) [14], Patient Scar Assessment Questionnaire (PSAQ) [15], and Patient-Reported Impact of Scars Measure (PRISM) [16]. All were designed and/or validated with the goal of assessing QOL and/or patient satisfaction in patients with surgical and/or non-burn traumatic scars.…”

Section: Resultsmentioning

confidence: 99%

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Patient-Reported Outcome Instruments for Surgical and Traumatic Scars: A Systematic Review of their Development, Content, and Psychometric Validation

et al. 2016

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Background Patient-reported outcomes (PROs) are of growing importance in research and clinical care and may be used as primary outcomes or as compliments to traditional surgical outcomes. In assessing the impact of surgical and traumatic scars, PROs are often the most meaningful. To assess outcomes from the patient perspective, rigorously developed and validated PRO instruments are essential. Methods The authors conducted a systematic literature review to identify PRO instruments developed and/or validated for patients with surgical and/or non-burn traumatic scars. Identified instruments were assessed for content, development process, and validation under recommended guidelines for PRO instrument development. Results The systematic review identified 6,534 articles. After review, we identified 4 PRO instruments meeting inclusion criteria: Patient and Observer Scar Assessment Scale (POSAS), Bock Quality of Life Questionnaire for Patients with Keloid and Hypertrophic Scarring (Bock), Patient Scar Assessment Questionnaire (PSAQ), and Patient-Reported Impact of Scars Measure (PRISM). Common concepts measured were symptoms and psychosocial well-being. Only PSAQ had a dedicated appearance domain. Qualitative data were used to inform content for the PSAQ and PRISM, and a modern psychometric approach (Rasch Measurement Theory) was used to develop PRISM and to test POSAS. Overall, PRISM demonstrated the most rigorous design and validation process, however was limited by the lack of a dedicated appearance domain. Conclusions PRO instruments to evaluate outcomes in scars exist but vary in terms of concepts measured and psychometric soundness. This review discusses the strengths and weaknesses of existing instruments, highlighting the need for future scar-focused PRO instrument development.

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Section: Resultsmentioning

confidence: 99%

“…The PRISM [16] is a 37-item instrument that measures QOL and physical symptoms in patients with various types of scars.…”

Section: Resultsmentioning

confidence: 99%

Patient-Reported Outcome Instruments for Surgical and Traumatic Scars: A Systematic Review of their Development, Content, and Psychometric Validation

et al. 2016

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“…Despite that the internal consistency of the instrument was good (Cronbach alpha = 0.84), it is clear that criteria by which patients assess their scar are highly subjective, various, and difficult to capture [28], resulting in a weak intersubjective comparability of judgment. Pain, color, and thickness were the significant contributing factors to the overall satisfaction at multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Quality of Scar after Total Thyroidectomy: A Single Blinded Randomized Trial Comparing Octyl-Cyanoacrylate and Subcuticular Absorbable Suture

et al. 2013

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Objective. To compare the quality of resulting scar at 6 weeks after total thyroidectomy with the use of the tissue adhesive octyl-cyanoacrylate or subcuticular absorbable suture for the closure of cervicotomy. Material and Methods. There are 50 patients undergoing a cervicotomy for total thyroidectomy. Twenty-five patients were randomly assigned to closure with tissue adhesive and 25 with subcuticular absorbable suture. At week 6 the scar was evaluated by blinded assessors with the Italian version of POSAS questionnaire, a validated wound scale composed of an observer's and a patient's subscale. Results. Assessment of scar appearance showed a statistically significant difference (p = 0. 038) in favor of subcuticular suture with respect to tissue adhesive on observer's assessment. The difference on patients' self-assessment was not significant. A multivariate analysis of six qualitative features of scars showed a significant influence on assessment for hyperpigmentation and relief of scar. The Italian version of POSAS proved to be reliable. Conclusion. Though tissue adhesive represents a valid method of skin closure, subcuticular absorbable suture provides a better aesthetic outcome in small cervical incisions in the early phase after thyroid surgery.

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“…Dermal postoperative repair produces scar tissue that can cause significant psychological and physical consequences [1,2]. With an estimated 55 million elective operations occurring each year in the developed world alone [3] and confirmation that most patients (irrespective of age, gender and ethnicity) believe that even a small improvement in scarring is worthwhile [4], any research that may help improve scar outcome is meaningful.…”

Section: Introductionmentioning

confidence: 99%

Does taping torso scars following dermatologic surgery improve scar appearance?

Rosengren

Askew

Heal

et al. 2013

Dermatol Pract Concept

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Background:Studies show that patients are significantly less satisfied with torso scars than scars elsewhere. Though not an uncommon practice, it is unknown if application of adhesive tapes following dermatological surgery help improve cosmesis.Objective:To determine the effect of taping sutured torso wounds on overall scar appearance, scar width and patient satisfaction with the scar.Patients/Methods:Participants having elliptical torso skin excisions in a primary care setting in regional Australia were randomized in a single-blinded, controlled trial to 12 weeks taping (intervention) or usual care (control) following deep and subcuticular suturing. A blinded assessor reviewed scars at three and six months.Results:Of 195 participants recruited, 136 (63 taped, 73 controls) completed six months of follow-up. Independent blinded assessment of overall scar appearance was significantly better in taped participants (p= 0.004). Taping reduced median scar width by 1 mm (p=0.02) and when stratified by gender, by 3.0 mm in males (p=0.04) and 1.0 mm in females (p=0.2). High participant scar satisfaction was not further improved by taping.Conclusion:Taping elliptical torso wounds for 12 weeks after dermatologic surgery improved scar appearance at six months.

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The Patient-Reported Impact of Scars Measure: Development and Validation

Cited by 57 publications

References 41 publications

Patient-Reported Outcome Instruments for Surgical and Traumatic Scars: A Systematic Review of their Development, Content, and Psychometric Validation

Patient-Reported Outcome Instruments for Surgical and Traumatic Scars: A Systematic Review of their Development, Content, and Psychometric Validation

Quality of Scar after Total Thyroidectomy: A Single Blinded Randomized Trial Comparing Octyl-Cyanoacrylate and Subcuticular Absorbable Suture

Does taping torso scars following dermatologic surgery improve scar appearance?

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