Burn Scar Evaluation Using the Cutometer® MPA 580 in Comparison to “Patient and Observer Scar Assessment Scale” and “Vancouver Scar Scale”

Burn scars are one of the most resistant and disfiguring scars to be treated by cosmetic and plastic surgery. The challenge remains not only with the damaged top layer but also with singeing and ablation of underlying appendages, vessels, nerves and glandular tissues depending upon the depth and degree of burns. Aim: To improve structural and cosmetic outcome of a burn scar with a cocktail of platelet rich plasma therapy, ablative Pixel Erbium: YAG laser and micro needling. Methods: Five patients of post burn scars were selected for a cocktail treatment of pixel Erbium: YAG laser(Alma lasers, Harmony Platform; 1300mj/p, 5 passes), micro needling radiofrequency (De age: 3mm depth at 35w output, 3 passes) and platelet rich plasma therapy (Two Renew cell kits containing total 27 ml of whole blood). Micro needling radiofrequency was done first followed by instillation of platelet rich plasma (.05ml at a gap of 0.5 cm) each through insulin syringe and ablative laser was done last of all under local anesthesia cream. The sessions were repeated every three weeks for total 3 sessions. Results: There were 2 males and 3 females with post burns scars and all 5 patients completed the study. The scars were assessed using the POSAS (Patient and Observer Scar Assessment Scale). All patients were assessed for the improvement in pigmentation, vascularity, relief in terms of skin texture, thickness, pliability in a scale of 0-10 and also for the appearance of hair follicles (yes/ no). Maximum improvement of 3.8 points was noted in mean values of pigmentation, while thickness and vascularity showed a difference of 1.4 points each in the mean value. The values obtained in Patient Scar Assessment Scale based on the questionnaire are maximum improvement of 4.2 points was seen in mean values of Colour, while mean values of Pain showed improvement of 1.2 points. There was appearance of new hair follicles in 4 out of 5 patients. Conclusion: Platelet rich plasma cocktail can help in creating new skin by resurfacing old scarred skin, rejuvenating dermis and sub cutis, activating dormant hair follicles and forming new vessels and nerves by repairing damaged appendages.

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Burn scar assessment: A systematic review of objective scar assessment tools

Burns ◽

10.1016/j.burns.2010.03.016 ◽

2010 ◽

Vol 36 (8) ◽

pp. 1157-1164 ◽

Cited By ~ 70

Author(s):

Nele Brusselaers ◽

Ali Pirayesh ◽

Henk Hoeksema ◽

Jozef Verbelen ◽

Stijn Blot ◽

...

Keyword(s):

Systematic Review ◽

Assessment Tools ◽

Burn Scar ◽

Scar Assessment

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Japan Scar Workshop (JSW) Scar Scale (JSS) for Assessing Keloids and Hypertrophic Scars

Textbook on Scar Management ◽

10.1007/978-3-030-44766-3_15 ◽

2020 ◽

pp. 133-140

Author(s):

Rei Ogawa

Keyword(s):

Hypertrophic Scar ◽

Assessment Tool ◽

Treatment Method ◽

Response To Therapy ◽

Assessment Scale ◽

Response To Treatment ◽

Hypertrophic Scars ◽

Scar Assessment ◽

Appropriate Treatment

AbstractThe Vancouver scar scale, the Manchester scar scale, and the Patient and Observer Scar Assessment Scale (POSAS) are all very well-known scar evaluation methods. These tools are based on a number of scar variables, including color, height, and pliability. However, since all were mainly developed to evaluate burn scars, they are difficult to use in clinical practice for keloids and hypertrophic scars. This is because these pathological scars require both differential diagnosis and a way to evaluate their response to therapy. The Japan Scar Workshop (JSW) has sought to develop a scar assessment scale that meets these clinical needs. The first version of this scar assessment tool was named the JSW scar scale (JSS), and it was reported in 2011. In 2015, the revised second version was reported. The JSS consists of two tables. One is a scar classification table that is used to determine whether the scar is a normal mature scar, a hypertrophic scar, or a keloid. This grading system helps the user to select the most appropriate treatment method for the scar. The other table in the JSS is an evaluation table that is used to judge the response to treatment and for follow-up. Both tables contain sample images of each subjective keloid/hypertrophic scar item that allow the user to evaluate each item without hesitation.

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Keystone-design perforator island flaps for the management of complicated epidermoid cysts on the back

Scientific Reports ◽

10.1038/s41598-019-51289-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 4

Author(s):

Chi Sun Yoon ◽

Hyo Bong Kim ◽

Young Keun Kim ◽

Hoon Kim ◽

Kyu Nam Kim

Keyword(s):

Postoperative Complications ◽

Medical Records ◽

Summary Score ◽

Assessment Scale ◽

Complete Excision ◽

Epidermoid Cysts ◽

Scar Assessment ◽

Tension Change ◽

The Mean ◽

Surgical Modality

Abstract Complicated epidermoid cysts (ECs) occur commonly on the back, but few reports have described their management. We present our experience in managing patients with ECs on the back using a keystone-design perforator island flap (KDPIF) reconstruction, thereby focusing on reduction and redistribution of wound tension. Altogether, 15 patients (average age, 48.067 ± 14.868 years) underwent KDPIF reconstructions after complete excision of complicated ECs on the back. We retrospectively reviewed the medical records and clinical photographs of all patients. Final scar appearance was evaluated using the Patient and Observer Scar Assessment Scale (POSAS). All patients had ruptured ECs, while 6 patients also had cellulitis of the surrounding tissues. All defects, after complete excision of ECs and debridement of surrounding unhealthy tissues, were successfully covered with KDPIF. The mean ‘tension-change’ at the defect and donor sites was −4.73 ± 0.21 N and −4.88 ± 0.25 N, respectively (p < 0.001). The mean ‘rate of tension-change’ at the defect and donor sites was −69.48 ± 1.7% and −71.16 ± 1.33%, respectively (p < 0.001). All flaps survived with no postoperative complications. The mean observer scar assessment scale (OSAS) summary score and patient scar assessment scale (PSAS) total score were 14.467 ± 5.069 and 15.6 ± 6.512, respectively. Overall, we suggest that KDPIF reconstruction is a good surgical modality for the management of complicated ECs on the back.

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