Objective Burn Scar Assessment in Clinical Practice Using the Cutometer©: Introduction and Validation of a Standardized Measurement Protocol

Overview

Journal J Burn Care Res

Publisher Oxford University Press

Specialty Emergency Medicine

Date 2022 Oct 27

PMID 36300728

Authors

Felix J Klimitz

Hubert Neubauer

Annette Stolle

Sabine Ripper

Simeon C Daeschler

Martin Aman

Arne Boecker

Benjamin Thomas

Ulrich Kneser

Leila Harhaus

Affiliations

Soon will be listed here.

Abstract

An objective burn scar assessment is essential to informed therapeutic decision-making and to monitor scar development over time. However, widely employed scar rating scales show poor inter-rater reliability. For this study we developed a standardized measurement protocol for the Cutometer© applicable for objective burn scar assessment in everyday clinical practice. We developed a measurement protocol for the Cutometer© MPA 580 including a scar site relocation technique based on anatomical landmarks. The protocol emerged through several steps: Identifying key factors for valid and reliable measurements, preliminary testing, specification of technical details, refining the protocol and final testing. Consecutively, the protocol was validated for inter-rater reliability by assessing 34 burn scars in 17 patients by four clinicians and computing an Intra-class Correlation Coefficient (ICC). Parameter R0, representing scar pliability, was identified as the best suited output parameter yielding excellent inter-rater reliability for average measures (ICC 0.92 [95% CI 0.86; 0.96]) and acceptable reliability for single measures (ICC: 0.74 [0.61; 0.84]). The pressure applied on the measuring probe was identified as an influential confounding factor for reliable measurements. Rater gender did not influence reliability of measurements. The introduced standardized measurement protocol for the Cutometer© MPA 580 enables an objective and reliable burn scar assessment for clinical as well as research purposes.

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