title: Burn scar assessment: a systematic review of different scar scales.
abstract: BACKGROUND
  Scars can be devastating and disfiguring, because they are clearly visible, stigmatizing, and permanent reminders of the initial accident or surgical event. Yet, there is still no consensus about the optimal scale or tool to assess the characteristics and evolution. Our aim was to evaluate the clinical importance of scar scales specifically developed for burn scars.
  
  
  METHODS
  The systematic literature search involved PubMed and the Web of Science (including Science Citation Index).
  
  
  RESULTS
  The search resulted in 29 articles (including seven reviews) dealing with a new, modified, or validated scale. Scar scales assess several characteristics, of which color, pliability, and thickness were considered the most important. Physical limitation, pain, and pruritus are often more disturbing than the appearance of the scar, and are therefore also introduced in scar evaluation, as well as the interference with daily life activities (e.g., psychologic impact).
  
  
  CONCLUSIONS
  In contrast to the more objective scar assessment tools, scar scales usually cover more aspects of the scars and are less time-consuming in clinical practice. However, no strong conclusions can be made about their efficacy and validity. In addition to digital photography, scar scales are a valuable instrument in the clinical evaluation and follow-up of scars.
authors.affiliation: Department of General Internal Medicine, Infectious Diseases and Psychosomatic Medicine, Ghent University Hospital, Ghent, Belgium. Nele.Brusselaers@Ugent.be
authors.forename: Nele
authors.initials: N
authors.lastname: Brusselaers
authors.forename: Ali
authors.initials: A
authors.lastname: Pirayesh
authors.forename: Henk
authors.initials: H
authors.lastname: Hoeksema
authors.forename: Jozef
authors.initials: J
authors.lastname: Verbelen
authors.forename: Stijn
authors.initials: S
authors.lastname: Blot
authors.forename: Stan
authors.initials: S
authors.lastname: Monstrey
mesh_terms: D002056:Burns / Q000473:pathology*; D002921:Cicatrix / Q000473:pathology*; D006801:Humans; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*