The Importance of Psychometric and Physical Scales for the Evaluation of the Consequences of Scars-A Literature Review

Overview

Journal Clin Pract

Publisher MDPI

Specialty General Medicine

Date 2023 Mar 24

PMID 36961059

Authors

Gabriel Mihai Mekeres

Camelia Liana Buhas

Andrei Nicolae Csep

Corina Beiusanu

Gineta Andreescu

Paula Marian

Cornel Dragos Cheregi

Radu Fodor

Felicia Manole

Affiliations

Soon will be listed here.

Abstract

Background: Scars affect patients after trauma, burns, or surgical procedures and can generate both physical and psychosocial changes. The aesthetic damage represents the modification of a person's physical appearance, in its bodily integrity, causing numerous sufferings and determining social or economic consequences. The aim of this research is to evaluate the advantages and disadvantages offered by the available psychosocial and physical scar scales in assessing the physical, aesthetic, psychosocial, and juridical consequences of scars. This will aid to inform medical examiners about the most valued existing scales to allow them to select the most appropriate instrument to manage their patient.

Methods: A broad search of relevant scientific studies on the psychosocial determinants of post-traumatic and surgical scars was conducted by using the following international database tools: PsycINFO, MedLine Social Science Index, Scopus, Web of Science, published from 1960 until 2022.

Results: We analyzed 63 scientific studies to assess the advantages and limits of several psychometric and physical scar evaluation scales.

Conclusions: The researchers analyzed in this review highlight the advantages and limitation of existing instruments, evidencing the demand for future scar evaluation instruments and a scar-assessing algorithm that takes into account the physical, aesthetic, psychosocial, and legal consequences of scars.

Citing Articles

Fractional carbon dioxide laser treatment of hypertrophic scar clinical and histopathological evaluation.

Keshk Z, Salah M, Samy N Lasers Med Sci. 2025; 40(1):137.

PMID: 40069407 PMC: 11897074. DOI: 10.1007/s10103-025-04371-5.

The Emotional Aftermath of Surviving an Attempted Intimate Partner Homicide.

Avieli H Qual Health Res. 2024; 35(1):44-55.

PMID: 39091209 PMC: 11626850. DOI: 10.1177/10497323241245643.

Surgical scar management - an evaluation of surgical techniques.

Caita G, Lascu C, Bodog F, Buhas C, Voita-Mekeres F, Voita G Med Pharm Rep. 2024; 97(2):149-153.

PMID: 38746026 PMC: 11090281. DOI: 10.15386/mpr-2701.

Relationship Between Symptom Burden and Self-Management Among Patients with Chronic Heart Failure: A Cross-Sectional Study.

Li J, Feng L, Shui X, Deng C, Hu A Patient Prefer Adherence. 2023; 17:1909-1921.

PMID: 37577359 PMC: 10417586. DOI: 10.2147/PPA.S419796.

References

Mekeres G, Voita-Mekeres F, Tudoran C, Buhas C, Tudoran M, Racovita M . Predictors for Estimating Scars' Internalization in Victims with Post-Traumatic Scars versus Patients with Postsurgical Scars. Healthcare (Basel). 2022; 10(3). PMC: 8951544. DOI: 10.3390/healthcare10030550. View

Brown B, Moss T, McGrouther D, Bayat A . Skin scar preconceptions must be challenged: importance of self-perception in skin scarring. J Plast Reconstr Aesthet Surg. 2009; 63(6):1022-9. DOI: 10.1016/j.bjps.2009.03.019. View

Attoe C, Pounds-Cornish E . Psychosocial adjustment following burns: An integrative literature review. Burns. 2015; 41(7):1375-84. DOI: 10.1016/j.burns.2015.02.020. View

Peinemann F, Behrouz-Pirnia A . Quality issues identified in systematic reviews on early laser intervention to reduce scar formation in wound healing. J Plast Reconstr Aesthet Surg. 2020; 73(7):1357-1404. DOI: 10.1016/j.bjps.2020.03.003. View

van der Wal M, Verhaegen P, Middelkoop E, van Zuijlen P . A clinimetric overview of scar assessment scales. J Burn Care Res. 2012; 33(2):e79-87. DOI: 10.1097/BCR.0b013e318239f5dd. View

Russo M, Bolcato M, Sabadin V, Aprile A . The medico-legal assessment of aesthetic damage. A correlation analysis between experts and an operative proposal. Leg Med (Tokyo). 2019; 40:47-53. DOI: 10.1016/j.legalmed.2019.07.006. View

Guest E, Griffiths C, Harcourt D . A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services. Scars Burn Heal. 2018; 4:2059513118764881. PMC: 5987094. DOI: 10.1177/2059513118764881. View

Mundy L, Miller H, Klassen A, Cano S, Pusic A . Patient-Reported Outcome Instruments for Surgical and Traumatic Scars: A Systematic Review of their Development, Content, and Psychometric Validation. Aesthetic Plast Surg. 2016; 40(5):792-800. PMC: 5505642. DOI: 10.1007/s00266-016-0642-9. View

Burd A, Huang L . Hypertrophic response and keloid diathesis: two very different forms of scar. Plast Reconstr Surg. 2005; 116(7):150e-157e. DOI: 10.1097/01.prs.0000191977.51206.43. View

10.

Pusic A, Klassen A, Scott A, Cano S . Development and psychometric evaluation of the FACE-Q satisfaction with appearance scale: a new patient-reported outcome instrument for facial aesthetics patients. Clin Plast Surg. 2013; 40(2):249-60. DOI: 10.1016/j.cps.2012.12.001. View

11.

MacLeod R, Shepherd L, Thompson A . Posttraumatic stress symptomatology and appearance distress following burn injury: An interpretative phenomenological analysis. Health Psychol. 2016; 35(11):1197-1204. DOI: 10.1037/hea0000391. View

12.

Klassen A, Ziolkowski N, Mundy L, Miller H, McIlvride A, DiLaura A . Development of a New Patient-reported Outcome Instrument to Evaluate Treatments for Scars: The SCAR-Q. Plast Reconstr Surg Glob Open. 2018; 6(4):e1672. PMC: 5977950. DOI: 10.1097/GOX.0000000000001672. View

13.

Brusselaers N, Pirayesh A, Hoeksema H, Verbelen J, Blot S, Monstrey S . Burn scar assessment: a systematic review of different scar scales. J Surg Res. 2010; 164(1):e115-23. DOI: 10.1016/j.jss.2010.05.056. View

14.

Ostlie D, Sharp N, Thomas P, Sharp S, Holcomb 3rd G, St Peter S . Patient scar assessment after single-incision versus four-port laparoscopic cholecystectomy: long-term follow-up from a prospective randomized trial. J Laparoendosc Adv Surg Tech A. 2013; 23(6):553-5. DOI: 10.1089/lap.2013.0245. View

15.

Beausang E, Floyd H, Dunn K, Orton C, Ferguson M . A new quantitative scale for clinical scar assessment. Plast Reconstr Surg. 1998; 102(6):1954-61. DOI: 10.1097/00006534-199811000-00022. View

16.

Fearmonti R, Bond J, Erdmann D, Levinson H . A review of scar scales and scar measuring devices. Eplasty. 2010; 10:e43. PMC: 2890387. View

17.

Economopoulos K, Petralias A, Linos E, Linos D . Psychometric evaluation of Patient Scar Assessment Questionnaire following thyroid and parathyroid surgery. Thyroid. 2012; 22(2):145-50. DOI: 10.1089/thy.2011.0265. View

18.

Roques C, Teot L . A critical analysis of measurements used to assess and manage scars. Int J Low Extrem Wounds. 2007; 6(4):249-53. DOI: 10.1177/1534734607308249. View

19.

Sidgwick G, McGeorge D, Bayat A . A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring. Arch Dermatol Res. 2015; 307(6):461-77. PMC: 4506744. DOI: 10.1007/s00403-015-1572-0. View

20.

Draaijers L, Tempelman F, Botman Y, Tuinebreijer W, Middelkoop E, Kreis R . The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg. 2004; 113(7):1960-5. DOI: 10.1097/01.prs.0000122207.28773.56. View