Assessing Scar Outcomes Using Objective Scar Measurement Tools: An Adjunct to Validated Scar Evaluation Scales

Background: The assessment of scar outcomes is important to both patient care and research focused on understanding the results of medical and surgical interventions. The Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) are validated and simple instruments to assess scars. However, these subjective scales have shortcomings. The VSS fails to capture patient perception and has indeterminate validity and reliability. The POSAS captures patient perception, but the observer scale has been shown to have moderate amounts of interrater variability. Studies highlighting the ability of objective scar assessment tools to produce reliable and reproducible results are needed. In this study, the authors aimed to validate the use of the FibroMeter, ElastiMeter, and SkinColorCatch as objective adjuncts in the assessment of hypertrophic scar and keloid outcomes. Methods: In this prospective single-center study, scars were assessed using the VSS, the POSAS, and the objective study tools (FibroMeter, ElastiMeter, and SkinColorCatch). Correlations between the different methods of scar assessment were measured. Results: The FibroMeter and SkinColorCatch showed significant correlations with the VSS total and the observer POSAS total. The ElastiMeter showed significant correlations with both the patient and observer POSAS totals. Unexpected correlations between ElastiMeter measurements and the vascularity or pigmentation of scars indicate that scoring of these categories may be influenced by how severe the scar looks to the observer subjectively, underscoring the need for reliable objective scar assessment tools. Conclusion: The results highlight the ability of the FibroMeter, ElastiMeter, and SkinColorCatch to assess scars, and demonstrate their potential in serving as important adjuncts to previously validated scar assessment scales.