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Carrière ME, Mokkink LB, Tyack Z, Westerman MJ, Pijpe A, Pleat J, van de Kar AL, Brown J, de Vet HCW, van Zuijlen PPM. Development of the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS) 3.0: a qualitative study. Qual Life Res 2023; 32:583-592. [PMID: 36355319 PMCID: PMC9911488 DOI: 10.1007/s11136-022-03244-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE The Patient and Observer Scar Assessment Scale (POSAS) is widely used for measurements of scar quality. This encompasses visual, tactile and sensory characteristics of the scar. The Patient Scale of previous POSAS versions was lacking input from patients. Therefore, the aim of this study was to develop the POSAS3.0, Patient Scale with involvement of adults patients with all scar types, complying with the highest clinimetric standards. METHODS From February 2018 to April 2019, a series of six focus group interviews were performed in the Netherlands and Australia to identify scar quality characteristics that adults with scars consider to be important. All focus groups were transcribed, anonymized and analysed using a thematic analysis. Relevant characteristics were formulated into items, resulting in a Dutch and English version of the Patient Scale. These drafts were pilot tested in Australia, the Netherlands and the United Kingdom, and refined accordingly. RESULTS A total of 21 relevant scar quality characteristics were identified during the focus groups. Two distinct versions of the POSAS3.0, Patient Scale were developed. The Generic version contains 16 items and can be used for all scar types, except linear scars. The Linear Scar version of the Patient Scale contains the same 16 items, with an extra item referring to the widening of scar margins. All included items are rated on a verbal rating scale with five response options. CONCLUSION Two versions of the POSAS3.0 Patient Scale were developed. Further field tests are being performed to establish the measurement properties and scoring algorithm of the scales.
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Affiliation(s)
- M. E. Carrière
- grid.16872.3a0000 0004 0435 165XDepartment of Epidemiology and Data Science, Amsterdam UMC (location VUmc), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.415746.50000 0004 0465 7034Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands ,grid.16872.3a0000 0004 0435 165XDepartment of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC (location VUmc), Amsterdam Movement Sciences, Amsterdam, The Netherlands ,grid.418147.f0000 0004 9238 8347Association of Dutch Burn Centers, Beverwijk, The Netherlands
| | - L. B. Mokkink
- grid.16872.3a0000 0004 0435 165XDepartment of Epidemiology and Data Science, Amsterdam UMC (location VUmc), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Z. Tyack
- grid.1003.20000 0000 9320 7537Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - M. J. Westerman
- grid.16872.3a0000 0004 0435 165XDepartment of Epidemiology and Data Science, Amsterdam UMC (location VUmc), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Division of Life Science, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - A. Pijpe
- grid.415746.50000 0004 0465 7034Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands ,grid.16872.3a0000 0004 0435 165XDepartment of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC (location VUmc), Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - J. Pleat
- grid.418484.50000 0004 0380 7221Department of Plastic and Reconstructive Surgery, North Bristol NHS Trust, Bristol, UK
| | - A. L. van de Kar
- grid.440209.b0000 0004 0501 8269Department of Plastic, Reconstructive en Handsurgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - J. Brown
- grid.416100.20000 0001 0688 4634Burn Center, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - H. C. W. de Vet
- grid.16872.3a0000 0004 0435 165XDepartment of Epidemiology and Data Science, Amsterdam UMC (location VUmc), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - P. P. M. van Zuijlen
- grid.415746.50000 0004 0465 7034Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands ,grid.16872.3a0000 0004 0435 165XDepartment of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC (location VUmc), Amsterdam Movement Sciences, Amsterdam, The Netherlands ,Pediatric Surgical Centre, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
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van de Kar AL, Houge G, Shaw AC, de Jong D, van Belzen MJ, Peters DJM, Hennekam RCM. Keloids in Rubinstein-Taybi syndrome: a clinical study. Br J Dermatol 2014; 171:615-21. [PMID: 25132000 DOI: 10.1111/bjd.13124] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rubinstein-Taybi syndrome (RSTS) is a multiple congenital anomalies-intellectual disability syndrome. One of the complications is keloid formation. Keloids are proliferative fibrous growths resulting from excessive tissue response to skin trauma. OBJECTIVES To describe the clinical characteristics of keloids in individuals with RSTS reported in the literature and in a cohort of personally evaluated individuals with RSTS. PATIENTS AND METHODS We performed a literature search for descriptions of RSTS individuals with keloids. All known individuals with RSTS in the Netherlands filled out three dedicated questionnaires. All individuals with (possible) keloids were personally evaluated. A further series of individuals with RSTS from the U.K. was personally evaluated. RESULTS Reliable data were available for 62 of the 83 Dutch individuals with RSTS and showed 15 individuals with RSTS (24%) to have keloids. The 15 Dutch and 12 U.K. individuals with RSTS with keloids demonstrated that most patients have multiple keloids (n > 1: 82%; n > 5: 30%). Mean age of onset is 11·9 years. The majority of keloids are located on the shoulders and chest. The mean length × width of the largest keloid was 7·1 × 2·8 cm, and the mean thickness was 0·7 cm. All affected individuals complained of itching. Generally, treatment results were disappointing. CONCLUSIONS Keloids occur in 24% of individuals with RSTS, either spontaneously or after a minor trauma, usually starting in early puberty. Management schedules have disappointing results. RSTS is a Mendelian disorder with a known molecular basis, and offers excellent opportunities to study the pathogenesis of keloids in general and to search for possible treatments.
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Affiliation(s)
- A L van de Kar
- Department of Plastic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, 1105 AZ, The Netherlands; Department of Plastic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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van der Meer JG, Moerman E, van de Kar AL, Vermaas M, Gerhards MF. Lotus petal perforator flap for reconstruction of an extended chronic presacral defect after radiotherapy and rectal cancer resection. Colorectal Dis 2014; 16:O220-2. [PMID: 24308419 DOI: 10.1111/codi.12511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 10/15/2013] [Indexed: 02/08/2023]
Abstract
AIM As a result of their extent and complexity, pelvic wounds after surgery for anorectal malignancy often require a multidisciplinary approach to accomplish closure. This report describes a successful reconstruction using the lotus petal perforator flap. METHOD This flap is based on perforators of the internal pudendal artery and was partially depithelialized for plugging the defect. RESULTS Wound healing was achieved after 12 days. CONCLUSION The lotus petal flap is a relatively simple and successful choice for reconstruction of an extended chronic presacral defect after radiotherapy and rectal cancer resection.
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Affiliation(s)
- J G van der Meer
- Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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