Burn scar assessment: a systematic review of different scar scales.
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.
Brusselaers
Nele
N
Department of General Internal Medicine, Infectious Diseases and Psychosomatic Medicine, Ghent University Hospital, Ghent, Belgium. Nele.Brusselaers@Ugent.be
Pirayesh
Ali
A
Hoeksema
Henk
H
Verbelen
Jozef
J
Blot
Stijn
S
Monstrey
Stan
S
D002056:Burns / Q000473:pathology*; D002921:Cicatrix / Q000473:pathology*; D006801:Humans; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*