In a clinimetric analysis, 3D stereophotogrammetry was found to be reliable and valid for measuring scar volume in clinical research.

Objectives: Volume is an important feature in the evaluation of hypertrophic scars and keloids. Three-dimensional (3D) stereophotogrammetry is a noninvasive technique for the measurement of scar volume. This study evaluated the reliability and validity of 3D stereophotogrammetry for measuring scar volume.

Intralesional cryotherapy for treatment of keloid scars: a prospective study.

Background: Intralesional cryotherapy is a novel treatment for keloid scars in which the scar is frozen from inside. Published results are promising, but the treatment has only been tested in a Caucasian patient population. Therefore, the authors evaluated intralesional cryotherapy in a patient population including different Fitzpatrick skin types (I through VI).

The hand held Doppler device for the detection of perforators in reconstructive surgery: what you hear is not always what you get.

Background: Perforator-based flaps have become indispensable in the treatment of burn scars. Pre-operative perforator mapping is often performed by use of the hand held Doppler device, partly due to its convenience and the low costs. We expected to find sufficient evidence in literature to support the use of the device, however available literature showed a distinct lack of clinimetric studies that adequately tested the reliability.

Skin stretching for primary closure of acute burn wounds.

Background: In burn care, a well-acknowledged problem is the suboptimal scar outcome from skin grafted burn wounds. With the aim of improving this, we focused on a new technique: excision of the burn wound followed by primary closure, thereby using a skin-stretching device to stretch the adjacent healthy skin. The short- and long-term effect of Skin Stretch was compared to split skin grafting (SSG) in a randomized controlled trial.

Differential item functioning in the Observer Scale of the POSAS for different scar types.

Purpose: To investigate whether the Observer Scale of the Patient and Observer Scar Assessment Scale (POSAS) can serve as a generic measure for scar quality across different scar types.

Methods: A collection of POSAS scores derived from several clinical trials on burn (n = 404), linear (n = 384), and keloidal scars (n = 282) was analyzed using the partial credit model of the Rasch analysis package RUMM2030.

Results: Differential item functioning (DIF) was observed for the Observer Scale of the POSAS between the three scar types for the items pliability, thickness, and surface area, which could be solved by item splitting.

Three-dimensional digital stereophotogrammetry: a reliable and valid technique for measuring scar surface area.

Background: The surface area of scars is an important outcome parameter in scar assessment. It is often used to quantify the extent of scar features, such as pigmentation disturbances, hypertrophy, and contracture. Currently available techniques for measuring the surface area are known to be cumbersome or do not meet the basic clinimetric criteria (i.

Objective color measurements: clinimetric performance of three devices on normal skin and scar tissue.

Color measurements are an essential part of scar evaluation. Thus, vascularization (erythema) and pigmentation (melanin) are common outcome parameters in scar research. The aim of this study was to investigate the clinimetric properties and clinical feasibility of the Mexameter, Colorimeter, and the DSM II ColorMeter for objective measurements on skin and scars.

Clinical effectiveness of dermal substitution in burns by topical negative pressure: a multicenter randomized controlled trial.

Previous research has shown clinical effectiveness of dermal substitution; however, in burn wounds, only limited effect has been shown. A problem in burn wounds is the reduced take of the autograft, when the substitute and graft are applied in one procedure. Recently, application of topical negative pressure (TNP) was shown to improve graft take.

Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient.

Sustainable effect of skin stretching for burn scar excision: long-term results of a multicenter randomized controlled trial.

Purpose: Primary wound closure of large defects after burn scar excision may be facilitated by intraoperative stretching of the adjacent skin. In a randomized controlled trial (RCT), the effect of skin stretching for wound closure after scar excision (SS) was compared to scar excision without additional techniques (SE). Short-term results already showed that in the SS group larger scars could be excised in a one-step procedure.

Rasch analysis of the Patient and Observer Scar Assessment Scale (POSAS) in burn scars.

Purpose: The Patient and Observer Scar Assessment Scale (POSAS) is a questionnaire that was developed to assess scar quality. It consists of two separate six-item scales (Observer Scale and Patient Scale), both of which are scored on a 10-point rating scale. After many years of experience with this scale in burn scar assessment, it is appropriate to examine its psychometric properties using Rasch analysis.

Objective scar assessment tools: a clinimetric appraisal.

Background: Scars may lead to an array of cosmetic, psychological, and functional problems. Different scar features can be distinguished (i.e.

A cadaver study of the vascular territories of dominant and nondominant internal mammary artery perforators.

The perfusion territory of the pedicled internal mammary artery perforator flap has been described, but the number of perforators to be included in the flap's pedicle is controversial. We studied the vascular territory of the dominant perforator and the contribution of additional nondominant perforators to it. Therefore, the dominant perforators in 9 fresh cadavers and the nondominant perforators in 4 of these, were injected with water-based ink.

An objective device for measuring surface roughness of skin and scars.

Background: Scar formation remains a major clinical problem; therefore, various therapies have been developed to improve scar quality. To evaluate the effectiveness of these therapies, objective measurement tools are necessary. An appropriate, objective measuring instrument for assessment of surface roughness is not yet available in a clinical setting.

Topical silicone gel versus placebo in promoting the maturation of burn scars: a randomized controlled trial.

Background: Silicone sheets are widely used in the treatment of hypertrophic scars, although application around joints may cause limited adherence and reduced movement. To approach these problems, a topical silicone gel was developed that can be applied easily in a thin layer, and that is nonrestrictive and less apparent. The objective of this study was to investigate the effectiveness of topical silicone gel in promoting the maturation of burn scars.

Anatomy of the vascular pedicle of the internal mammary artery perforator (IMAP) flap as applied for head and neck reconstruction.

Introduction: The vascular pedicle of the internal mammary artery perforator (IMAP) flap and its enhancement by inclusion of the internal mammary vessels up to the level of the first rib have not been systematically assessed anatomically, to date. This study assesses these features of this pedicle in light of the flap's application in head and neck reconstruction.

Material And Methods: The length of the dominant perforator and the enhanced vascular pedicle of the IMAP flap were measured in 27 fresh cadaveric hemi-thoraxes.

Biological background of dermal substitutes.

Dermal substitutes are of major importance in treating full thickness skin defects, both in acute and chronic wounds. In this review we will outline specific requirements of three classes of dermal substitutes: Biological and clinical requirements will be translated to composition, physical structure, immunological properties and cell-matrix interactions of the various materials. Important properties like pore size, cell adhesion sites (e.

Intra- and interobserver variability of aortic aneurysm volume measurement with fast CTA postprocessing software.

Purpose: To study inter- and intraobserver variability of volume measurements with a new, fast semi-automatic method and compare the results to a previously validated standard manual method for volume measurement.

Methods: Twenty abdominal computed tomographic angiography (CTA) datasets of patients with abdominal aortic aneurysms undergoing endovascular aneurysm repair (EVAR) were randomly selected from a clinical database (10 pre and 10 post EVAR). Aneurysm sac volume was measured by 2 independent observers using both the standard and semi-automatic methods.