Scarring Assessment and Wound Healing Evaluation

The Patient and Observer Scar Assessment Scale (POSAS) included the Patient Scar Assessment Scale (PSAS) and the Observer Scar Assessment Scale (OSAS), which were used to evaluate the surgical improvement at 3-, 6- and 12-month follow-up. The PSAS includes six items: pain, pruritus, color, stiffness, thickness and irregularity, while the 6 items included in OSAS are: vascularity, pigmentation, thickness, relief, pliability, and surface. Each item was graded on a 10-point scale (1 represented the best and 10 represented the worst), and the scores on all items were summed to obtain a total score ranging from 6 to 60 [26 (link)]. Recurrence of PS was defined as a POSAS thickness score 5. The aspect and scar width were individually monitored for 18 months [27 (link)]. Topical perfusion was measured with the PeriCam PSI System (Perimed, Sweden) using the Region of Interests (ROIs) method.
Wound eversion was objectively assessed with a ruler on the adjacent flat skin surface parallelly aside from the midpoint. Data were collected immediately after surgery and at 3, 6 and 12 months postoperatively. Complications such as wound dehiscence, seroma or hematoma, infection and spitting sutures were observed and recorded for at least 12 months after surgery.