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How to Assess Scar Quality in Pediatric Burn Patients: A Systematic Review on the Type and Content of Outcome

Frederique M Kemme1,2,3, Adinda Mieras1,2,3, Johannes C F Ket4

  • 1Alliance of Dutch Burn Care (ADBC), Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|May 3, 2025
PubMed

Insights

Assessing scar quality in pediatric burn patients is crucial. While clinician-reported outcome measures (CROMs) are common, patient-reported outcome measures (PROMs) are gaining traction, yet many tools need better validation for this population.

Area of Science:

  • Pediatric Burn Scar Assessment
  • Outcome Measurement in Rehabilitation
  • Dermatology and Regenerative Medicine

Background:

  • Scar quality assessment is vital for monitoring pediatric burn patients' progress and treatment efficacy.
  • Children are susceptible to long-term scarring, necessitating specialized evaluation methods.
  • Existing scar assessment tools may not be fully optimized for pediatric burn populations.

Purpose of the Study:

  • To provide a comprehensive overview of outcome measurement instruments for scar quality in pediatric burn patients.
  • To identify the most frequently used assessment tools and scar characteristics.
  • To evaluate the trend and suitability of patient-reported outcome measures (PROMs) in this demographic.

Main Methods:

  • Systematic literature search across PubMed, EMBASE, and Web of Science up to March 25, 2024.
  • Inclusion of original research studies in English focusing on scar quality in pediatric burn patients.
  • Categorization of identified instruments into clinician-reported outcome measures (CROMs), measurement devices, and PROMs.

Main Results:

  • 328 studies yielded 585 outcome measurement instruments.
  • Clinician-reported outcome measures (CROMs) comprised 53%, devices 25%, and PROMs 22%.
  • The (modified) Vancouver Scar Scale (m)(VSS), ultrasound, and POSAS Patient scale were most frequent; thickness and itch were key characteristics. PROM use increased post-2016.

Conclusions:

  • Clinician-reported outcome measures remain dominant, but patient-reported outcome measures show increasing use and importance.
  • Many instruments, including PROMs, lack specific design or validation for pediatric burn patients.
  • Further development and validation of scar assessment tools are needed to meet the unique requirements of pediatric burn survivors.

Keywords:
CROMPROMburnsmeasurement instrumentpediatricsscar quality

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