title: Scar Revision Surgery: The Patient's Perspective.
abstract: BACKGROUND
  Insufficient satisfaction outcome literature exists to assist consultations for scar revision surgery; such outcomes should reflect the patient's perspective. The aim of this study was to prospectively investigate scar revision patient satisfaction outcomes, according to specified patient-selection criteria.
  
  
  METHODS
  Patients (250) were randomly selected for telephone contacting regarding scar revisions undertaken between 2007-2011. Visual analogue scores were obtained for scars pre- and post-revision surgery. Surgery selection criteria were; 'presence' of sufficient time for scar maturation prior to revision, technical issues during or wound complications from the initial procedure that contributed to poor scarring, and 'absence' of site-specific or patient factors that negatively influence outcomes. Patient demographics, scar pathogenesis (elective vs. trauma), underlying issue (functional/symptomatic vs. cosmetic) and revision surgery details were also collected with the added use of a real-time, hospital database.
  
  
  RESULTS
  Telephone contacting was achieved for 211 patients (214 scar revisions). Satisfaction outcomes were '2% worse, 16% no change, and 82% better'; a distribution maintained between body sites and despite whether surgery was functional/symptomatic vs. cosmetic. Better outcomes were reported by patients who sustained traumatic scars vs. those who sustained scars by elective procedures (91.80% vs. 77.78%, P=0.016) and by females vs. males (85.52% vs. 75.36%, P<0.05), particularly in the elective group where males (36.17%) were more likely to report no change or worse outcomes versus females (16.04%) (P<0.01).
  
  
  CONCLUSIONS
  Successful scar revision outcomes may be achieved using careful patient selection. This study provides useful information for referring general practitioners, and patient-surgeon consultations, when planning scar revision.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK.
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Miranda
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK.
authors.forename: Anna Y
authors.initials: AY
authors.lastname: Allan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Butler
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Cussons
keywords: Patient satisfaction; Patient selection; Plastic surgery; Scarring; Standards