The evaluation of a clinical scar scale for porcine burn scars

Wang, Xue-Qing; Kravchuk, Olena; Liu, Pei-Yun; Kempf, Margit; Boogaard, Carolina V.D.; Lau, Peter; Cuttle, Leila; Mill, Julie; Kimble, Roy M.

doi:10.1016/j.burns.2008.10.005

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Volume 35, Issue 4 , Pages 538-546, June 2009

The evaluation of a clinical scar scale for porcine burn scars

Xue-Qing Wang
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia
- Corresponding author at: Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Level 3, Foundation Building, Herston Road, Herston, Brisbane 4029, Australia. Tel.: +61 7 3365 5019; fax: +61 7 3365 5455.
Olena Kravchuk
- Biometrics Unit of School of Land, Crop and Food Sciences, University of Queensland, Brisbane 4072, Australia
Pei-Yun Liu
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia
Margit Kempf
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia
Carolina V.D. Boogaard
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia
Peter Lau
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia
Leila Cuttle
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia
Julie Mill
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia
Roy M. Kimble
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia

Accepted 13 October 2008.

Abstract

This study describes the evaluation of a clinical scar scale for our porcine burn scars, which includes scar cosmetic outcome, colour, height and hair, supplemented with reference porcine scar photographs representing each scar outcome and scar colour scores. A total of 72 porcine burn scars at week 6 after burn were rated in vivo and/or on photographs. Good agreements were achieved for both intra-rater reliability (correlation is 0.86–0.98) and inter-rater reliability (ICC=80–85%). The results showed statistically significant correlations for each pair in this clinical scar scale (p<0.01), with the best correlation found between scar cosmetic outcome and scar colour. A multivariate principle components analysis revealed that this clinical scar assessment was highly correlated with scar histology, wound size, and re-epithelialisation data (p<0.001). More severe scars are clinically characterised by darker purple colouration, more elevation, no presence of hair, histologically by thicker scar tissue, thinner remaining normal dermis, are more likely to have worse contraction, and slower re-epithelialisation. This study demonstrates that our clinical scar scale is a reliable, independent and valuable tool for assessing porcine burn outcome and truthfully reflects scar appearance and function. To our knowledge, this is the first study demonstrating a high correlation between clinical scar assessment and scar histology, wound contraction and re-epithelialisation data on porcine burn scars. We believe that the successful use of porcine scar scales is invaluable for assessing potential human burn treatments.