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[libribook.com] Traumatic Scar Tissue Management 1st Edition
Scar assessment toolsAs with other assessment procedures, scar assessments can be objective orsubjective. Objective assessments provide a quantitative measurement ofthe scar, whereas subjective assessments are observer dependent.Quantitative assessment of scars requires devices to measure their physicalattributes. Subjective methods to assess scar provide a qualitativemeasurement of scar by a patient or clinician.Semiquantitative methods to assess scars have been developed by usingscales to make subjective methods more objective.
Scar scalesScar scales can be used to quantify initial scar appearance and trackchanges over time. There are currently five commonly used scar scalesdesigned to assess subjective parameters in an objective way: theVancouver Scar Scale (VSS), Manchester Scar Scale (MSS), Patient andObserver Scar Assessment Scale (POSAS), Visual Analog Scale (VAS) andStony Brook Scar Evaluation Scale (SBSES). These observer-dependentscales are best used to determine change within an individual rather thanbetween individuals.None of these scar scales measure:• Amount of total body surface area that is scarred• Functional disability caused by the effects of pain and pruritus• Subsequent impact on quality of life and activities of daily living.Therefore it is recommended that no one assessment tool be usedexclusively as several tools will be necessary in order to capture all thenecessary information needed to monitor changes and evaluate treatmenteffectiveness.Three of the most accessible and appropriate scales for use in MT practiceinclude the POSAS, the VSS and the VAS. PDF copies of these scales andinstructions on how to use them can be readily found on the internet.POSASPOSAS is aimed at measuring the quality of scar tissue and includes acomprehensive list of items, based on clinically relevant scarcharacteristics. The observer scores: vascularization, pigmentation,thickness, surface roughness, pliability and surface area. The patientscores: pain, pruritus, color, thickness, relief, and pliability.All included items are scored on a 10-point scale:• 1 is given when the scar characteristic is comparable to ‘normal skin’
- Page 645 and 646: Clinical ConsiderationIt is importa
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- Page 651 and 652: Box 8.1Aside from obvious sexually
- Page 653 and 654: Box 8.2Eight principles that guide
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- Page 661 and 662: Interview exampleMary is a client w
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- Page 665 and 666: with traumatic scar tissue clients.
- Page 667 and 668: ‘Physicians’ perspective of mas
- Page 669 and 670: Referral exampleTonya, a 21-year-ol
- Page 671 and 672: Referral exampleJane experienced me
- Page 673 and 674: CHAPTER 9Assessment and treatmentHe
- Page 675 and 676: MT. Additionally, sometimes people
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- Page 679 and 680: Clinical ConsiderationReduction of
- Page 681 and 682: Clinical ConsiderationMT has been f
- Page 683 and 684: Clinical ConsiderationMassage can h
- Page 685 and 686: Health History and InterviewA stand
- Page 687 and 688: surrounding muscle structures that
- Page 689 and 690: we are gathering information about
- Page 691 and 692: Keep in mind that the therapist’s
- Page 693 and 694: Continuous evaluation during the se
- Page 695: Pre-treatment assessment/evaluation
- Page 699 and 700: response to negative pressure. It h
- Page 701 and 702: • Client self-management strategi
- Page 703 and 704: BindOnce barrier is reached or surp
- Page 705 and 706: Table 9.1Comparative of normal and
- Page 707 and 708: 2-3 times a year effectively addres
- Page 709 and 710: Myofascial meridian exampleSuperfic
- Page 711: Clinical ConsiderationKnee and back
- Page 715 and 716: Clinical ConsiderationApplication t
- Page 717 and 718: Pathophysiological ConsiderationMec
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- Page 721 and 722: Safety FirstMT appears to have few
- Page 723 and 724: Deep workThe deep techniques noted
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Scar scales
Scar scales can be used to quantify initial scar appearance and track
changes over time. There are currently five commonly used scar scales
designed to assess subjective parameters in an objective way: the
Vancouver Scar Scale (VSS), Manchester Scar Scale (MSS), Patient and
Observer Scar Assessment Scale (POSAS), Visual Analog Scale (VAS) and
Stony Brook Scar Evaluation Scale (SBSES). These observer-dependent
scales are best used to determine change within an individual rather than
between individuals.
None of these scar scales measure:
• Amount of total body surface area that is scarred
• Functional disability caused by the effects of pain and pruritus
• Subsequent impact on quality of life and activities of daily living.
Therefore it is recommended that no one assessment tool be used
exclusively as several tools will be necessary in order to capture all the
necessary information needed to monitor changes and evaluate treatment
effectiveness.
Three of the most accessible and appropriate scales for use in MT practice
include the POSAS, the VSS and the VAS. PDF copies of these scales and
instructions on how to use them can be readily found on the internet.
POSAS
POSAS is aimed at measuring the quality of scar tissue and includes a
comprehensive list of items, based on clinically relevant scar
characteristics. The observer scores: vascularization, pigmentation,
thickness, surface roughness, pliability and surface area. The patient
scores: pain, pruritus, color, thickness, relief, and pliability.
All included items are scored on a 10-point scale:
• 1 is given when the scar characteristic is comparable to ‘normal skin’
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