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Course of scar quality of donor sites following split skin graft harvesting: Comparison between patients and observers
Author(s) -
Legemate Catherine M.,
Ooms Pauline J.,
Trommel Nicole,
Goei Harold,
Lucas Ymke,
Middelkoop Esther,
Baar Margriet E.,
Vlies Cornelis H.
Publication year - 2020
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/wrr.12840
Subject(s) - medicine , scars , prospective cohort study , surgery , population , cohort , environmental health
There exists little to no data on the development of donor‐site scars that remain after split skin graft harvesting. The objectives of this study were to (a) examine changes in characteristics of donor‐site scar quality over time and (b) assess the agreement between patient‐reported and observer‐reported donor‐site scar quality in a burn population. A prospective cohort study was conducted including patients who underwent split skin grafting for their burn injury. Patients and observers completed the Patient and Observer Scar Assessment Scale (POSAS) for the first harvested donor site at 3 and 12 months post‐surgery. This study included 80 patients with a median age of 34 years. At 3 months post‐surgery, the patients scored the POSAS items itch and color as most deviant from normal skin, both improved between 3 and 12 months (3.1 vs 1.5 and 5.0 vs 3.5, respectively [ P < .001]). Other scar characteristics did not show significant change over time. The patients' overall opinion score improved from 3.9 to 3.2 ( P < .001). Observers rated the items vascularization and pigmentation most severe, only vascularization improved significantly between both time points. Their overall opinion score decreased from 2.7 to 2.3 ( P < .001). The inter‐observer agreement between patients and observers was considered poor (ICC < 0.4) at both time points. Results of current study indicate that observers underestimate the impact of donor‐site scars. This has to be kept in mind while guiding therapy and expectations. LEVEL OF EVIDENCE: II, prospective cohort study.