The Modified Patient and Observer Scar Assessment Scale: A Novel Approach to Defining Pathologic and Nonpathologic Scarring

Fearmonti, Regina M.; Bond, Jennifer; Erdmann, Detlev; Levin, L. Scott; Pizzo, Salvatore V.; Levinson, Howard

doi:10.1097/prs.0b013e3181f959e8

Cited by 63 publications

(47 citation statements)

References 19 publications

(23 reference statements)

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“…These fixed lesions cause pain, deformity, profound itching, and severe disability of joints [3–5]. Contractures as little as a 10% reduction in joint motion is clinically significant [6]. Current anti-HSc therapies are ineffective [7].…”

Section: Introductionmentioning

confidence: 99%

Angiotensin II stimulates canonical TGF-β signaling pathway through angiotensin type 1 receptor to induce granulation tissue contraction

Ehanire

Ren

Bond³

et al. 2014

J Mol Med

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Hypertrophic scar contraction (HSc) is caused by granulation tissue contraction propagated by myofibroblast and fibroblast migration and contractility. Identifying the stimulants that promote migration and contractility are key to mitigating HSc. AngiotensinII (AngII) promotes migration and contractility of heart, liver, and lung fibroblasts; thus, we investigated the mechanisms of AngII in HSc. Human scar and unwounded dermis were immunostained for AngII receptors AT1-receptor and AT2-receptor, and analyzed for AT1-receptor expression using western blot. In-vitro assays of fibroblast contraction and migration under AngII stimulation were conducted with AT1-receptor, AT2-receptor, p38, JNK, MEK, and ALK5 antagonism. Excisional wounds were created on AT1-receptor KO and WT mice treated with AngII ± Losartan, and ALK5 and JNK inhibitors SB-431542 and SP-600125 respectively. Granulation tissue contraction was quantified and wounds analyzed by immunohistochemistry. AT1-receptor expression was increased in scar, but not unwounded tissue. AngII induced fibroblast contraction and migration through AT1-receptor. Cell migration was inhibited by ALK5 and JNK, but not p38 or MEK blockade. In-vivo experiments determined that absence of AT1-receptor and chemical AT1-receptor antagonism diminished granulation tissue contraction while AngII stimulated wound contraction. AngII granulation tissue contraction was diminished by ALK5 inhibition, but not JNK. AngII, promotes granulation tissue contraction through AT1-receptor and downstream canonical TGFβ signaling pathway; ALK5. Further understanding the pathogenesis of HSc as an integrated signaling mechanism could improve our approach to establishing effective therapeutic interventions.

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Section: Introductionmentioning

confidence: 99%

Angiotensin II stimulates canonical TGF-β signaling pathway through angiotensin type 1 receptor to induce granulation tissue contraction

Ehanire

Ren

Bond³

et al. 2014

J Mol Med

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“…Many different scar scales have been published [9,11,12]. We, therefore, evaluated carefully which scar scale was going to assess our results most accurately.…”

Section: Discussionmentioning

confidence: 99%

Retroauricular full-thickness skin grafts in syndactyly repair: outcome and comparison with inguinal full-thickness skin grafts: retrospective (cross-sectional) study

Sulser

Kalisch

Weber

2016

Journal of Plastic Surgery and Hand Surgery

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“…All wounds were followed up and assessed by a plastic surgeon using the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) at the postoperative sixth month, [5,6] and the Fitzpatrick skin type classification scale was used for categorizing our patient's skin properties. [7] The VSS contains four variables with the following scores: pigmentation (normal 0, hypopigmentation 1, mixed 2, and hyperpigmentation 3), vascularity (normal 0, pink 1, red 2, and purple 3), flexibility (normal 0, supple 1, yielding 2, firm 3, ropes 4, and contracture 5), and height (flat= 0, <2 mm= 1, 2-5 mm= 2, and >5 mm= 3).…”

Section: Methodsmentioning

confidence: 99%

Patient perception, satisfaction and cosmetic results of surgical atrial septal defect closure: Minithoracotomy versus sternotomy

Kaya¹

2015

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada atriyal septal defekt (ASD) kapatılmasında kullanılan iki cerrahi teknik [sağ lateral minitorakotomi (RLMT) ve median sternotomi (MS)] karşılaştırıldı ve hasta memnuniyeti, kozmetik sonuçlar ve hasta algısı skar ve mental durum değerlendirilmesinde kullanılan testlerle ölçüldü.Ça lış ma pla nı: Çalışmaya MS yöntemi ile ameliyat edilen 14 (grup MS) ve RLMT yöntemi ile ameliyat edilen 12 (grup RLMT) hasta olmak üzere toplam 26 ASD hastası dahil edildi. Hastalar insizyon bölgelerine göre iki gruba ayrıldı. Hastaların insizyon skarları Vancouver Yara İzi Ölçeği (VSS) ve Hasta ve Gözlemci Yara İzi Değerlendirme (POSAS) kriterlerine göre objektif olarak değerlendirildi. Bunun yanı sıra, hastaların algısını ölçmek için hastalara Hasta Memnuniyeti Puanı (HMP), Beden Algısı Anketi (BAA) ve Hamilton Anksiyete Derecelendirme Ölçeği (HADÖ) uygulandı. Bul gu lar:Toplam hasta memnuniyeti RLMT grubunda MS grubundan daha fazla idi (p= 0.021). İki grup arasında VSS, BAA, HADÖ ve cilt tipi açısından anlamlı farklılık yoktu. Ortalama skar uzunluğu (p<0.0001), kardiyopulmoner baypas zamanı (p= 0.016) ve hastanede kalış süresi (p= 0.019) RLMT uygulanan hastalarda MS uygulanan hastalardan daha kısa idi.So nuç: Çalışmamız RLMT uygulanan hastaların skar sonuçlarından daha memnun olduğunu gösterdi. Hastaların skar özellikleri benzer olsa da insizyon yeri göğüs kafesine cerrahi girişim yapıldığının belli olmasını istemeyen hastaların kararına bağlı olabilir. Sağ lateral minitorakotomi hastanede kalış süresini de kısaltır. Bulgularımız ASD kapatılmasında en uygun cerrahi teknik hakkında ileri araştırmalara katkı sağlayabilir.Anah tar söz cük ler: Atriyal septal defekt; kozmetik sonuçlar; insizyon yeri; hasta memnuniyeti. ABSTRACTBackground:This study aims to compare two surgical techniques [right lateral minithoracotomy (RLMT) and median sternotomy (MS)] used to close atrial septal defects (ASD), and measure patient satisfaction, cosmetic results, and patient perception with tests used for evaluating scar and mental status.

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The Modified Patient and Observer Scar Assessment Scale: A Novel Approach to Defining Pathologic and Nonpathologic Scarring

Abstract: Background-Scarring is a highly prevalent and multifactorial process, yet no studies to date have attempted to distinguish pathologic from non-pathologic scarring.

Cited by 63 publications

References 19 publications

Angiotensin II stimulates canonical TGF-β signaling pathway through angiotensin type 1 receptor to induce granulation tissue contraction

Angiotensin II stimulates canonical TGF-β signaling pathway through angiotensin type 1 receptor to induce granulation tissue contraction

Retroauricular full-thickness skin grafts in syndactyly repair: outcome and comparison with inguinal full-thickness skin grafts: retrospective (cross-sectional) study

Patient perception, satisfaction and cosmetic results of surgical atrial septal defect closure: Minithoracotomy versus sternotomy

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