Objective Burn Scar Assessment in Clinical Practice Using the Cutometer©: Introduction and Validation of a Standardized Measurement Protocol

Abstract

An objective burn scar assessment is essential to informed therapeutic decision making and to monitor scar development over time. However, widely employed scar rating scales show poor inter-rater reliability. For this study we developed a standardized measurement protocol for the Cutometer © applicable for objective burn scar assessment in everyday clinical practice. We developed a measurement protocol for the Cutometer © MPA 580 including a scar site relocation technique based on anatomical landmarks. The protocol emerged through several steps: Identifying key factors for valid and reliable measurements, preliminary testing, specification of technical details, refining the protocol and final testing. Consecutively, the protocol was validated for inter-rater reliability by assessing 34 burn scars in 17 patients by four clinicians and computing an Intraclass Correlation Coefficient (ICC). Parameter R0, representing scar pliability, was identified as the best suited output parameter yielding excellent inter-rater reliability for average measures (ICC 0.92 [95% CI 0.86;0.96]) and acceptable reliability for single measures (ICC: 0.74 [0.61;0.84]). The pressure applied on the measuring probe was identified as an influential confounding factor for reliable measurements. Rater gender did not influence reliability of measurements. The introduced standardized measurement protocol for the Cutometer © MPA 580 enables an objective and reliable burn scar assessment for clinical as well as research purposes.

Skin mechanical properties measured with skin elasticity measurement device in patients with lymphedema: Scoping review

“…The application of skin elasticity meters for measuring skin mechanical properties has been insufficiently addressed in the literature for an extended period despite its demonstrated value in diverse fields, particularly in clinical medicine. 6 , 7 , 8 , 9 The predominance of palpatory assessments, such as “pitting edema,” 21 in the clinical management of lymphedema, may account for the limited use of skin elasticity meters for assessing skin mechanical properties in patients with lymphedema. Currently, a standardized protocol for objective measurement does not exist.…”

“… 3 Moreover, it has been applied in several studies within the cosmetic industry, 4 , 5 as well as in clinical settings for various skin diseases. 6 , 7 , 8 , 9 …”

Efficacy and Complications Associated with Acellular Dermal Substitute Use in the Treatment of Acute Burns: A Systematic Review and Meta-Analysis

“…With the notable exception of Shang et al [23], in which both the substitute and control scar quality worsened with time, most studies that assessed scar quality at multiple time points also demonstrated that scar quality of wounds treated with substitute improved over time as the scar matures, although this was not always significant compared to normal maturation. Whilst there was considerable heterogeneity in tools used to assess scar quality, the data suggest that the scar scales used all offer reasonable reliability and validity, although each is not without its flaws, whilst the Cutometer © offers a reliable, objective method of burn scar assessment [36,37].…”