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Kučinskaitė A, Stundys D, Gervickaitė S, Tarutytė G, Grigaitienė J, Tutkuvienė J, Jančorienė L. Aesthetic Evaluation of Facial Scars in Patients Undergoing Surgery for Basal Cell Carcinoma: A Prospective Longitudinal Pilot Study and Validation of POSAS 2.0 in the Lithuanian Language. Cancers (Basel) 2024; 16:2091. [PMID: 38893210 PMCID: PMC11171257 DOI: 10.3390/cancers16112091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Facial basal cell carcinoma (BCC) surgery enhances the quality of life (QoL) but leaves patients with inferior QoL, presumably caused by scarring, emphasizing the need to understand post-surgery aesthetic satisfaction. This study aimed to validate the Lithuanian version of the Patient and Observer Scar Assessment Scale (POSAS) 2.0 and utilise it to identify scar evaluation differences and correlations among POSAS scores and specific aesthetic facial regions, age, gender, surgery types, and short- and long-term QoL. Employing a prospective longitudinal design, 100 patients with facial scars after surgical BCC removal were enrolled. The validation phase confirmed the translated POSAS 2.0 psychometric properties, while the pilot phase used statistical analyses to compare scores among demographic and clinical groups and evaluate correlations between scar assessment and QoL. The findings indicate that the translated Lithuanian version of POSAS 2.0 exhibits good psychometric properties, revealing insights into aesthetic satisfaction with post-surgical facial scars and their impact on QoL. The Lithuanian version of the POSAS 2.0 was established as a valid instrument for measuring post-surgical linear scars. QoL with scar assessment statistically significantly correlates, 6 months after surgery, with worse scores, particularly notable among women, younger patients, and those with tumours in the cheek region.
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Affiliation(s)
| | - Domantas Stundys
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (J.G.); (L.J.)
| | - Simona Gervickaitė
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (S.G.); (J.T.)
| | - Gabrielė Tarutytė
- Department of Research and Innovation, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania;
- Institute of Applied Mathematics, Faculty of Mathematics and Informatics, Vilnius University, 03225 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania
| | - Jūratė Grigaitienė
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (J.G.); (L.J.)
| | - Janina Tutkuvienė
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (S.G.); (J.T.)
| | - Ligita Jančorienė
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (J.G.); (L.J.)
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Justicz N, Ryder CY, Rudy SF, Bellile EL, Kim JC, Baker S, Moyer JS. A Comparison of Pulsed Dye Laser and Dermabrasion After Nasal Reconstruction. Facial Plast Surg Aesthet Med 2024; 26:197-199. [PMID: 37205866 DOI: 10.1089/fpsam.2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Affiliation(s)
- Natalie Justicz
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
| | - C Yoonhee Ryder
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Shannon F Rudy
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Emily L Bellile
- Department of Biostatistics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jennifer C Kim
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Shan Baker
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jeffrey S Moyer
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
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Drake VE, Moyer JS. The Measure of a Scar: Patient Perceptions and Scar Optimization after Skin Cancer Reconstruction. Facial Plast Surg 2023; 39:501-507. [PMID: 37290453 DOI: 10.1055/s-0043-1769807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
In facial reconstruction after skin cancer resection, management and optimization of postoperative scar is a complex paradigm. Every scar is unique and presents a different challenge-whether due to anatomic, aesthetic, or patient-specific factors. This necessitates a comprehensive evaluation and an understanding of the tools at hand to improve its appearance. How a scar looks is meaningful to patients, and the facial plastic and reconstructive surgeon is tasked with its optimization. Clear documentation of a scar is critical to assess and determine optimal care. Scar scales such as the Vancouver Scar Scale, the Manchester Scar Scale, the Patient and Observer Assessment Scale, the Scar Cosmesis Assessment and Rating "SCAR" Scale, and FACE-Q, among others, are reviewed here in the context of evaluating postoperative or traumatic scar. Measurement tools objectively describe a scar and may also incorporate the patient's assessment of their own scar. In addition to physical exam, these scales quantify scars that are symptomatic or visually unpleasant and would be best served by adjuvant treatment. The current literature regarding the role of postoperative laser treatment is also reviewed. While lasers are an excellent tool to assist in blending of scar and decreasing pigmentation, studies have failed to evaluate laser in a consistent, standardized way that allows for quantifiable and predictable improvement. Regardless, patients may derive benefit from laser treatment given the finding of subjective improvement in their own perception of scar, even when there is not a significant change to the clinician's eye. This article also discusses recent eye fixation studies which demonstrate the importance of careful repair of large and central defects of the face, and that patients value the quality of the reconstruction.
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Affiliation(s)
- Virginia E Drake
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Livonia, Michigan
| | - Jeffrey S Moyer
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Livonia, Michigan
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Bastos LMH, Carvalho LP, Haddad GR, Miola AC, Schmitt JV. Curettage and electrocoagulation versus surgical excision in the treatment of low-risk basal cell carcinoma - Postoperative follow up and satisfaction at three months: randomized clinical trial. An Bras Dermatol 2022; 97:384-386. [PMID: 35241317 PMCID: PMC9133236 DOI: 10.1016/j.abd.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Luan Moura Hortencio Bastos
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Larissa Pierri Carvalho
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Gabriela Roncada Haddad
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Anna Carolina Miola
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Juliano Vilaverde Schmitt
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
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Voiță-Mekeres F, Buhaș CL, Mekeres GM, Tudoran C, Racovita M, Faur CI, Tudoran M, Abu-Awwad A, Voiță NC, Maghiar TA. Mekeres' Psychosocial Internalization Scale: A Scale for the Evaluation of Aesthetic Prejudice in Victims of Accidents and Violence. Healthcare (Basel) 2021; 9:healthcare9111440. [PMID: 34828487 PMCID: PMC8623774 DOI: 10.3390/healthcare9111440] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 01/10/2023] Open
Abstract
Background and objectives: One important forensic activity is the assessment of aesthetic injuries where expert criteria and analysis are insufficiently outlined due to the subjective elements related to the traumatized victim. Unaesthetic morphological changes may occur due to various circumstances committed under the Penal Code, resulting in permanent unaesthetic morphological scarring. Considering that most of the existing scales for the assessment of aesthetic prejudices refer only to morphometric changes, our aim was to create a modern method for the evaluation of aesthetic damage that also considers its social and psychological consequences. Materials and Methods: In this study, we developed the Mekereș Psychosocial Internalization Scale (MPIS), which proposes a clear boundary between the presence or absence of aesthetic damage. The traumatized person is evaluated after a minimum of six months (in the case of an average scar, necessary for defining the character of the scar) to assess changes in the physiognomy or even alterations in the victim’s aesthetic perception of their own body. Our study was conducted on 103 patients with scars, and the results were compared to 101 controls (subjects without scars). Results: Individuals with scars have a distorted perception (compared to controls) of the support provided by significant people [t (202) = 2.473; p = 0.01]. Hypothetically, they will most likely exhibit a nuanced socio-cognitive and psycho-emotional vulnerability that may be the source of future dysfunctions. The fidelity of the MPIS scale was estimated by employing Cronbach’s alpha coefficient, resulting in a value of 0.934 (15 items). The exploratory factorial analysis with Varimax rotation mode sustains a single dominant factor, indicating a good internal consistency. The results of this study provide evidence regarding the psychosocial or psychometric worthiness of MPIS. Conclusions: MPIS can be used for research and as an instrument to assess aesthetic damage or disfigurement by forensic physicians and lawyers.
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Affiliation(s)
- Florica Voiță-Mekeres
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (F.V.-M.); (C.L.B.); (M.R.); (N.C.V.); (T.A.M.)
| | - Camelia Liana Buhaș
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (F.V.-M.); (C.L.B.); (M.R.); (N.C.V.); (T.A.M.)
| | - Gabriel Mihai Mekeres
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (F.V.-M.); (C.L.B.); (M.R.); (N.C.V.); (T.A.M.)
- Correspondence: (G.M.M.); (C.T.); Tel.: +40-770-679-808 (G.M.M.); +40-722-669-086 (C.T.)
| | - Cristina Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania;
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania
- County Emergency Hospital, 300736 Timisoara, Romania
- Correspondence: (G.M.M.); (C.T.); Tel.: +40-770-679-808 (G.M.M.); +40-722-669-086 (C.T.)
| | - Mariana Racovita
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (F.V.-M.); (C.L.B.); (M.R.); (N.C.V.); (T.A.M.)
| | - Cosmin Ioan Faur
- Department XV, Orthopedy-Traumatology, Urology and Imagistical Medicine, Discipline of Orthopedy, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania; (C.I.F.); (A.A.-A.)
| | - Mariana Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania;
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania
- County Emergency Hospital, 300736 Timisoara, Romania
| | - Ahmed Abu-Awwad
- Department XV, Orthopedy-Traumatology, Urology and Imagistical Medicine, Discipline of Orthopedy, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania; (C.I.F.); (A.A.-A.)
| | - Nuțu Cristian Voiță
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (F.V.-M.); (C.L.B.); (M.R.); (N.C.V.); (T.A.M.)
| | - Teodor Andrei Maghiar
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (F.V.-M.); (C.L.B.); (M.R.); (N.C.V.); (T.A.M.)
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