A systematic review of objective burn scar measurements

BackgroundProblematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor. At present, there are few treatments available in the clinic to control adverse scarring, but experimental pharmacological anti-scarring strategies are now beginning to emerge. Their comparative success must be based on objective measurements of scarring, yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients. However, several techniques and devices are being introduced that allow objective analysis of the burn scar. The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.MethodsA systematic literature search was done using the Web of Science, PubMed and Cochrane databases. The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter- and intra-rater reproducibility, ease of use and cost.ResultsAfter duplicates were removed, 5062 articles were obtained in the search. After further screening, 157 articles which utilised objective burn scar measurement systems or tools were obtained. The scar measurement devices can be broadly classified into those measuring colour, metric variables, texture, biomechanical properties and pathophysiological disturbances.ConclusionsObjective scar measurement tools allow the accurate and reproducible evaluation of scars, which is important for both clinical and scientific use. However, studies to evaluate their relative performance and merits of these tools are scarce, and there remain factors, such as itch and pain, which cannot be measured objectively. On reviewing the available evidence, a panel of devices for objective scar measurement is recommended consisting of the 3D cameras (Eykona/Lifeviz/Vectra H1) for surface area and volume, DSM II colorimeter for colour, Dermascan high-frequency ultrasound for scar thickness and Cutometer for skin elasticity and pliability

Ultrasound assessment of muscle thickness and muscle crosssectional area: a reliability study

Purpose: Previous studies showed that ultrasound imaging is reliable when measuring the cross-sectional area (CSA) of a muscle. However, measurements of muscles could be affected by the level of experience of the observer. The aim of this pilot study was to investigate the reliability of observers when measuring the CSA and thickness of the rectus femoris (RF). Methods and Materials: Seven observers assessed eight different images of RF. On each image the CSA and thickness was measured three times using ImageJ. The measurements were analysed using IBM SPSS. Intraclass Correlation Coefficient (ICC) and Bland-Altman plots were used to analyse reliability. A Paired Sample T-Test was used to investigate any differences between the first and mean measurement recorded by the observers. Results: No significant differences were found between the first and mean of the repeated measures for CSA and thickness respectively (p = 0. 217- 0.817, p = 0.337-0.897). Intra-observer reliability shows excellent agreement between measurement one and the mean for each observer (CSA ICC = 0.987-1.000, thickness ICC = 0.996-1.000). High inter-observer reliability was found for both CSA (ICC = 0.938, 95% CI = 0.845-0.985) and thickness (ICC = 0.9774, 95% CI = 0.934-0.994). Agreement between an experienced and inexperienced observer was excellent (ICC = 0.991, 95% CI = 0.959-0.998). Conclusion: This pilot study shows that there is a high level of inter- and intra-observer reliability among the observers in measuring the CSA and thickness of the RF. It also shows that experience in ultrasound measurements is not a factor in reliability

Ultrasound assessment of muscle thickness and muscle crosssectional area: a reliability study

Purpose: Previous studies showed that ultrasound imaging is reliable when measuring the cross-sectional area (CSA) of a muscle. However, measurements of muscles could be affected by the level of experience of the observer. The aim of this pilot study was to investigate the reliability of observers when measuring the CSA and thickness of the rectus femoris (RF). Methods and Materials: Seven observers assessed eight different images of RF. On each image, the CSA and thickness were measured three times using ImageJ. The measurements were analyzed using IBM SPSS. Intraclass Correlation Coefficient (ICC) and Bland-Altman plots were used to analyze reliability. A Paired Sample T-Test was used to investigate any differences between the first and mean measurement recorded by the observers. Results: No significant differences were found between the first and mean of the repeated measures for CSA and thickness respectively (p = 0.217-0.817, p = 0.337-0.897). Intra-observer reliability shows excellent agreement between measurement one and the mean for each observer (CSA ICC = 0.987-1.000, thickness ICC = 0.996-1.000). High inter-observer reliability was found for both CSA (ICC = 0.938, 95% CI = 0.845-0.985) and thickness (ICC = 0.9774, 95% CI = 0.934-0.994). Agreement between an experienced and inexperienced observer was excellent (ICC = 0.991, 95% CI = 0.959-0.998). Conclusion: This pilot study shows that there is a high level of inter- and intraobserver reliability among the observers in measuring the CSA and thickness of the RF. It also shows that experience in ultrasound measurements is not a factor in reliability.info:eu-repo/semantics/publishedVersio