title: Comparison of patient satisfaction and practitioner satisfaction with wound appearance after traumatic wound repair.
abstract: BACKGROUND
  Existing cosmetic scales for wounds are based only on practitioners' evaluations. They have not been validated using the patient's assessment.
  
  
  OBJECTIVE
  To validate a previously developed wound cosmesis scale by determining the relationship between patient and practitioner assessments of cosmetic outcome following traumatic wound repair.
  
  
  METHODS
  A convenience sample of patients with lacerations repaired in an ED were evaluated at the time of suture removal. Practitioners assigned 0 or 1 point each for the presence or absence of a step-off of borders; contour irregularities; margin separation; edge inversion; excessive distortion; and overall appearance. A total cosmetic score was calculated by adding the categories above. As previously defined, a score of 6 was considered optimal; < 6 was considered "suboptimal." Patients, blinded to the physician score, assessed their degrees of satisfaction with the cosmetic outcome of the wounds using a 100-mm visual analog scale (VAS). Because VAS scores were not normally distributed, practitioner scores were compared with patient satisfaction scores using a Mann-Whitney U test.
  
  
  RESULTS
  125 patients were enrolled, of whom 64% were male; the median age was 19.5 years (interquartile range = 8-33 years). Wounds were located predominantly on the face, scalp, or neck (47%) and upper extremity (35%), and had a median length of 2 cm. The 86 lacerations given optimal practitioner scores had a median patient satisfaction score of 97 mm; the 39 "suboptimal" lacerations had a median patient satisfaction score of 87 mm (p = 0.0006).
  
  
  CONCLUSIONS
  Lacerations that practitioners considered to have optimal cosmetic appearances at the time of suture removal received higher patient satisfaction scores than did lacerations considered to be suboptimal. This provides a measure of validity to this 6-item categorical cosmetic scale.
authors.affiliation: University Medical Center, Department of Emergency Medicine, State University of New York, Stony Brook 11794-7400, USA. asinger@epo.som.sunysb.edu
authors.forename: A J
authors.initials: AJ
authors.lastname: Singer
authors.forename: A L
authors.initials: AL
authors.lastname: Church
authors.forename: K
authors.initials: K
authors.lastname: Forrestal
authors.forename: M
authors.initials: M
authors.lastname: Werblud
authors.forename: S M
authors.initials: SM
authors.lastname: Valentine
authors.forename: J E
authors.initials: JE
authors.lastname: Hollander
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009518:New York; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D015203:Reproducibility of Results; D013518:Surgery, Plastic / Q000592:standards; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*