title: Transepidermal water loss measured with the Tewameter TM300 in burn scars.
abstract: Transepidermal water loss (TEWL) is a physiological characteristic to measure the efficiency of the skin barrier. The aim was to investigate the reliability of the Tewameter TM300 for the assessment of TEWL (g/m2/h) in burn scars. Also the relation between TEWL scar values and scar quality parameters was investigated. Three different study areas (scar, healthy adjacent and contralateral skin) were assessed in 55 adult patients. The intra- and inter-observer reliability were tested using the intra-class correlation coefficient (ICC) and the standard error of measurement (SEM). The inter-observer reliability for the three areas was excellent with ICC values between 0.85 and 0.94. SEM values were between 1.76 and 3.97g/m2/h. Bland-Altman plots showed relatively wide LoA values for scar and healthy skin. Mean TEWL scar values were significantly higher than healthy skin (p<0.001). Significant correlations were found between TEWL hypertrophic scar values and erythema (r=0.60, p=0.001) and a negative correlation for weeks after burn (r=-0.61, p=0.001). TEWL values were significantly different between 3 and 6 months and 3 and 12 months old scars (respectively p=0.021 and p=0.002). To evaluate the skin barrier function over time as a measure for scar maturation, Tewameter TM300 measurements have to be performed according to strict and standardized protocols.
authors.affiliation: Dept Plastic, Reconstructive and Hand Surgery, VU University Medical Center, MOVE Research Institute, 1007 MB Amsterdam, The Netherlands; Association of Dutch Burn Centers, 1940 EA Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, 1942 LE Beverwijk, The Netherlands.
authors.forename: Kim L M
authors.initials: KL
authors.lastname: Gardien
authors.affiliation: Association of Dutch Burn Centers, 1940 EA Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, 1942 LE Beverwijk, The Netherlands. Electronic address: dbaas@rkz.nl.
authors.forename: Dominique C
authors.initials: DC
authors.lastname: Baas
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, 1007 MB Amsterdam, The Netherlands.
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
authors.affiliation: Dept Plastic, Reconstructive and Hand Surgery, VU University Medical Center, MOVE Research Institute, 1007 MB Amsterdam, The Netherlands; Association of Dutch Burn Centers, 1940 EA Beverwijk, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Middelkoop
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns; D002921:Cicatrix; D003430:Cross-Sectional Studies; D019719:Diagnostic Equipment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014870:Water Loss, Insensible; D055815:Young Adult
keywords: Burn scar; Reliability; Scar quality; Tewameter; Transepidermal water loss