Objective Assessment Techniques: Physiological Parameters in Scar Assessment

Abstract

AbstractIn order to assess new and often costly treatments, the need for objective scar measurement tools has become increasingly important. A combination of subjective and objective measures should be the aim of every researcher. Quantitative assessment of scars requires devices to measure their physical and physiological properties. Physiological scar parameters are scar characteristics relevant to pathological scarring which cannot be seen with the bare eye. This also means that they can only be assessed with objective assessment tools.Skin hydration is defined as the water content of the epidermis and the dermis, and the ability of the skin to retain water is important to avoid dry appearance of the skin and prolonged inflammation in scarring. Many approaches exist to measure skin water content. One single method is often not enough to capture all the relevant information. Trans-epidermal water loss, stratum corneum water content, and dermal water content are equally important and related to each other.Scar maturation has been related to transcutaneous oxygen tension, and it is hypothesized that low levels of transcutaneous oxygen pressure in evolving scars result from low oxygen diffusibility through scar tissue.Tactile sensitivity of the skin can be measured by esthesiometers. The Semmes-Weinstein monofilament test is found to be a feasible and reliable outcome measure to evaluate touch perception threshold in older upper extremities burn scars.