Skin Deep: Perception of Scars After Cranial Vault Reconstruction

Roy, Tulsi; Chavez, Julia; Reid, Russell R.

doi:10.1177/1055665620984349

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…We did not find an association between patient gender and mean POSAS or EQ-5D scores. This is consistent with previous scar satisfaction literature [ 8 , 14 - 16 ] and contradicts widely held gender stereotypes. It is important that physicians are aware of this to avoid male patients with scar concerns being overlooked.…”

Section: Discussionsupporting

confidence: 92%

The Attitudes of Patients Toward Orthopaedic Post-surgical Scars

Ho,

Hughes,

Fleming

2023

Cureus

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Background Post-surgical scars (PSS) are an expected consequence of surgery. Several factors have previously been associated with PSS satisfaction including patient age and time elapsed post-operative. Little data are available regarding patient attitudes toward orthopaedic PSS. Knowledge of patient attitudes and the various associated factors may allow physicians to administer peri-operative care to mitigate the potential negative effects of PSS. Our study aims to investigate the attitudes of patients toward their PSS using quantitative scar assessment scales and to identify factors associated with PSS satisfaction. Methods We conducted a retrospective study with a follow-up. We included all patients with orthopaedic PSS on their upper or lower limbs between two and 18 weeks postoperative attending Cork University Hospital, Ireland, between February and August 2022. Patients completed an initial baseline questionnaire and then a follow-up questionnaire six months post-operative. The Patient and Observer Scar Assessment Scale (POSAS) evaluated PSS satisfaction. The European Quality of Life 5 Domain (EQ-5D), alongside several Likert scales, evaluated the patient's quality of life (QoL). Results In total, 91 patients were included. The mean POSAS score was 28.41 (95% CI, 25.85-30.97). Younger patient age (p=0.045) and decreased time passed post-operatively (p=0.002) were associated with poorer PSS satisfaction. Patients reporting their PSS appearing worse than expected were more likely to agree that their QoL had been adversely affected by it (p=0.001). Conclusion Most patients were satisfied with their orthopaedic PSS. This study identified several factors associated with poor PSS satisfaction. Our finding, which associated patient scar expectations and QoL, is novel and has not been previously examined. Accordingly, peri-operative interventions, including scar expectation management, may be implemented to mitigate scar-related QoL impact.

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Section: Discussionsupporting

confidence: 92%

The Attitudes of Patients Toward Orthopaedic Post-surgical Scars

Ho,

Hughes,

Fleming

2023

Cureus

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“…As in previous reports, parents in our OCVR group felt that the zig-zag bicoronal scar was a source of stigma, especially in boys with short hair where it was more visible. 24 Given that metopic craniosynostosis is diagnosed in boys over three times more often than in girls, this should influence the choice of surgical technique. 25 This study is the first to recruit adolescents to assess aesthetic outcomes in patients with craniosynostosis.…”

Section: Discussionmentioning

confidence: 99%

Superior Long-term Appearance of Strip Craniectomy Compared with Cranial Vault Reconstruction in Metopic Craniosynostosis

Badiee

Popowitz

Mark

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Strip craniectomy with orthotic helmet therapy (SCOT) is an increasingly supported treatment for metopic craniosynostosis, although the long-term efficacy of deformity correction remains poorly defined. We compared the longterm outcomes of SCOT versus open cranial vault reconstruction (OCVR). Methods: Patients who underwent OCVR or SCOT for isolated metopic synostosis with at least 3 years of follow-up were identified at our institution. Anthropometric measurements were used to assess baseline severity and postoperative skull morphology. Independent laypersons and craniofacial surgeons rated the appearance of each patient's 3D photographs, compared to normal controls. Results: Thirty-five patients were included (15 SCOT and 20 OCVR), with similar follow-up between groups (SCOT 7.9 ± 3.2 years, OCVR 9.2 ± 4.1 years). Baseline severity and postoperative anthropometric measurements were equivalent. Independent adolescent raters reported that the forehead, eye, and overall appearance of SCOT patients was better than OCVR patients (P < 0.05, all comparisons). Craniofacial surgeons assigned Whitaker class I to a greater proportion of SCOT patients with moderate-to-severe synostosis (72.2 ± 5.6%) compared with OCVR patients with the same severity (33.3 ± 9.2%, P = 0.02). Parents of children who underwent SCOT reported equivalent satisfaction with the results of surgery (100% versus 95%, P > 0.99), and were no more likely to report bullying (7% versus 15%, P = 0.82). Conclusions: SCOT was associated with superior long-term appearance and perioperative outcomes compared with OCVR. These findings suggest that SCOT should be the treatment of choice for patients with a timely diagnosis of metopic craniosynostosis.

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“…4,8,15,30 In addition, failure to improve the cosmetic aspect can result in abnormal psychosocial development during childhood and adolescence which can ultimately lead to anxiety, self-consciousness, and depression. 20,23 Therefore, children with both syndromic and nonsyndromic craniosynostosis should have developmental, behavioral, and mental health support from the time of diagnosis. 31 These substantial and far-reaching consequences underline the importance of providing data related to prevalence of craniosynostosis and specific suture type among various ethnicities of patients.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that White patients receive surgery to repair craniosynostosis at an earlier age than non-White patients 4 . Roy et al 23 found that the mean age for surgery in White children was 7.2 and 9.1 months in African American and Hispanic children. Shweikeh et al 4 found that White patients had an average age of 6.1 months at the time of surgery, African American patients had a mean age of 10.9 months and Hispanics had a mean age of 9.1 months.…”

Section: Discussionmentioning

confidence: 99%

Nonsyndromic Craniosynostosis Correlation Between Ethnicity, Race, and Pattern of Affected Suture Type: Meta-Analysis

Benaroch,

Brozynski,

Seyidova

et al. 2024

Journal of Craniofacial Surgery

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Background: Previous studies have sought to analyze risk factors associated with craniosynostosis and while syndromic craniosynostosis is often linked to genetic mutations, the factors impacting nonsyndromic cases are less investigated. The aim of current meta-analysis is to evaluate the relationship between ethnicity and suture type in nonsyndromic craniosynostosis patients. Methods: The search term “craniosynostosis [Title/Abstract] AND (race [Title/Abstract] OR ethnicity [Title/Abstract])) NOT (syndrome [Title/Abstract])” was used to search the PubMed, Cochrane, and MEDLINE databases. Analyses were conducted separately for each racial and ethnic group for each suture type cohort. Odds ratios were conducted for each suture cohort and confounders were adjusted using linear mixed-effect models. Because of the homogeneity of the populations and categorical nature of the classification, binary logistic regression was run on aggregate data. Results: The literature search yielded 165 articles. After reviewing titles, abstracts, and manuscript contents of these articles, 5 studies were ultimately included in a meta-analysis. Studies with missing data for a particular cohort or variable were excluded from the respective analysis. Hispanic children had higher odds of sagittal suture involvement (OR: 1.53, P<0.001), whereas Asian had coronal suture (OR: 2.47, P<0.001). Both Asian and African American children had significantly lower odds of sagittal suture involvement (OR: 0.50, P<0.001 and OR: 0.7, P=0.04, respectively). Conclusion The relationship between ethnicity and craniosynostosis has been suggested as a risk factor, but without definitive conclusion. Present meta-analysis findings demonstrated association between ethnicity and suture type, however further research with larger scale and geographically varied data is warranted.

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Skin Deep: Perception of Scars After Cranial Vault Reconstruction

Cited by 7 publications

References 18 publications

The Attitudes of Patients Toward Orthopaedic Post-surgical Scars

The Attitudes of Patients Toward Orthopaedic Post-surgical Scars

Superior Long-term Appearance of Strip Craniectomy Compared with Cranial Vault Reconstruction in Metopic Craniosynostosis

Nonsyndromic Craniosynostosis Correlation Between Ethnicity, Race, and Pattern of Affected Suture Type: Meta-Analysis

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