Development of a histomorphologic scale to quantify cutaneous scars after burns

Area of Science:

• Dermatology
• Wound Healing Research
• Biomedical Engineering

Background:

• Cutaneous scarring is an inevitable outcome of adult wound healing.
• Quantifying scar severity is challenging due to a lack of standardized assessment tools.
• Burn injuries frequently lead to significant scarring, necessitating reliable evaluation methods.

Purpose of the Study:

• To develop and validate a novel histomorphologic scale for quantifying scar severity following cutaneous burn injury.
• To compare the reliability of the histomorphologic scale with a visual analog scale (VAS) for gross scar appearance.

Main Methods:

• A histomorphologic scale was developed evaluating features like hyperkeratosis, epidermal hyperplasia, scar depth, fibroplasia, vascularity, and adnexal absence.
• Scores were assigned based on the presence of normal or abnormal histological findings and scar depth.
• A visual analog scale (VAS) was used for independent gross scar assessment by two investigators.

Main Results:

• The histomorphologic scale demonstrated high intraobserver reliability (correlation of 0.95 for total score).
• Inter- and intraobserver reliability for the gross scar VAS were both 0.8.
• The correlation between the histomorphologic scale and the gross scar VAS was moderate (0.38).

Conclusions:

• A reliable histomorphologic method for quantifying cutaneous scars has been established.
• A reliable visual analog scale (VAS) for scar assessment was also validated.
• The histomorphologic scale and the gross VAS demonstrated limited correlation, suggesting they capture different aspects of scar quality.