How to assess postsurgical scars: a review of outcome measures

Complications of surgical incision include pathological scars with functional, cosmetic or psychological consequences. Postsurgical scar assessment is fundamental for a complete functional evaluation and as an outcome measure. Scar assessment scales are here reviewed and discussed from a clinical and psychometric point of view, with a clear definition of different scar parameters.

An extensive review of the English-language literature was conducted using the Medline database.

Four scales that satisfy psychometrical criteria were identified: Vancouver Scar Scale (VSS), Patient and Observer Scar Assessment Scale (POSAS), Manchester Scar Scale (MSS) and Stony Brook Scar Evaluation Scale (SBSES).

To date, VSS is the most widely used rating scale for scars but POSAS appears the most comprehensive, taking into account the important aspect of patient's perspective. The MSS has been never used for research, while SBSES has only been very recently proposed.