Flickr

The way patients rate their scars can be highly influenced by many factors such as the location of the scar (visible or hidden), psychological factors such as the memory of the trauma or injury associated with the scar and even how others react to them and their scars including the clinicians themselves.

临床医生自己也不能幸免。They are susceptible to various factors that can influence how they rate a patient’s scar. A clinician who is less experienced in scars or has not seen many severe scars may rate less severe scars higher.

Even what you’ve just seen previously in the same day can influence this.一项研究done by the School of Psychology in the University of Sydney, showed that we are likely to rate a face as more attractive depending on the attractiveness of the previous face.

Science has also showed that we cannot always trust our own eyes either when rating a scar, as a最近高度热潮的话题the “Blue and black dress” shows, there can be significant differences in human colour perception such that a dress that is blue and black to some can be interpreted by others as gold and white.

烧伤疤痕研究的一个主要问题是，我们在大大依赖疤痕的视觉评级来确定干预是否有效。主观疤痕得分，例如温哥华疤痕量表（VSS），患者和观察者疤痕评估量表（POSAS）是伯恩斯领域评估和得分疤痕最广泛使用的方法，因为这些得分在低成本和培训要求方面是有利的。

随着各种新的手术和非手术技术的出现，在疤痕管理方面具有有希望的潜力，对可靠的客观疤痕评估的需求比以前更大。

However these scores are not quantitative and as previously mentioned, can vary widely between different assessors (patients or observers) depending on various factors. Thus, any perceived change (or lack of change) in the scores over time may not be indicative of the true evolution of the scars.

Objective scar assessments on the other hand should provide reproducible and quantitative scores regardless of the assessors. With the emergence of various new surgical and non-surgical technologies that have promising potential in the management of scars, the need for reliable objective scar assessments to back up their claims is greater than before.

Recently, an article entitled “a systematic review of objective burn scar measurements”发表在烧伤和创伤，建议使用可靠，友好且易于使用的一系列客观疤痕测量工具。

Currently available and utilized objective measurements can be grouped into the following categories:

• 颜色：用颜色测量探针和相机对疤痕中红斑和色素沉着的定量。
• Physical dimensions: the measurement of surface area, thickness and volume of scars with 2D /3D camera systems and high frequency ultrasound probes.
• Texture: the texture or roughness of the scar surface with advanced textural imaging systems.
• 生物力学特性：包括用吸力和非弹药设备的疤痕的粘弹性特性的测量。
• 生理特性：包括测量水含量或疤痕组织的透射水分流失和氧合。

新的和令人兴奋的技术也正在出现，例如无创的体内成像技术，这些技术将能够分析疤痕各种成分的形态结构

此外，新的和令人兴奋的技术也正在出现，例如非侵入性体内成像技术，这些技术将能够分析疤痕的各个组件的形态结构（例如，胶原束取向），只有以前才能通过活检的组织病理学分析样品。

None if not all of the existing objective scar measurement devices have been developed for the primary purpose of the measurement of scars and thus have several limitations to their use especially in the large, heterogeneous scars seen in severe burns. Therefore there needs to be a push for clinicians and academics to work closer with the SME’s to encourage further advancement in this important field.