Patient Scar Assessment Questionnaire Scores Research Articles

Application of Transvaginal Natural Orifice Specimen Extraction Surgery in Urological Surgery.

Background: To summarize and analyze the application of transvaginal natural orifice specimen extraction surgery (TV-NOSES) in the operation of renal carcinoma, upper tract urothelial carcinoma, and bladder cancer. Methods: Fifty-seven female patients who underwent 3D laparoscopic radical surgery for urinary tumors and TV-NOSES were analyzed retrospectively. The basic clinical data, perioperative-related data, postoperative complications, and related indexes of postoperative functional evaluation were analyzed and evaluated. Results: All 57 operations were successfully performed according to the original plan. One patient developed mild vaginal infection after operation, which was cured after symptomatic treatment. The visual analog scale scores at 24 and 48 hours after operation were 2.5 (1-4) and 1.1 (0-2), respectively. Patient scar assessment questionnaire scores at 3 months after operation were 37.1 (32-48). Pelvic floor distress inventory-short form 20 scores at preoperative and postoperative 3 months were 5.9 (3-9) and 6.3 (3-9), respectively, and the difference was not statistically significant (P = .48). There was no significant difference in female sexual function index scores between preoperative and postoperative 3 months (P = .82). Conclusions: TV-NOSES in urological surgery is feasible and practical. In addition, this technique further reduces wound pain and wound-related complications without affecting postoperative sexual function and pelvic floor function. The successful development of this technique has laid a solid foundation for further clinical application and promotion. Clinical Trial Registration number: 22/141-3342.

Donor-Site Morbidity After Autologous Fascia Lata Harvest for Arthroscopic Superior Capsular Reconstruction: A Midterm Follow-up Evaluation.

Background:Autologous fascia lata (AFL) graft use in arthroscopic superior capsular reconstruction (ASCR) is effective for the treatment of irreparable rotator cuff tears (RCTs). Although donor-site morbidity (DSM) is a recurrent argument against AFL graft use, scientific evidence for this argument is lacking.Purpose:To report the midterm clinical follow-up evaluation of DSM in ASCR using minimally invasively harvested AFL grafts and compare thigh function and patient satisfaction with those of an unharvested control group.Study Design:Cohort study; Level of evidence, 3.Methods:Of 66 consecutive patients who underwent ASCR using a minimally invasively harvested AFL graft, 39 patients with a minimum follow-up of 24 months were retrospectively evaluated (ASCR group) and compared with 39 randomly selected patients who underwent arthroscopic RCT repair by the same surgeons (control group). The functional outcomes of both thighs were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patient satisfaction was evaluated using the Patient Scar Assessment Questionnaire (PSAQ) and a subjective questionnaire. Pain was quantified using a visual analog scale (VAS).Results:The ASCR group had a mean age of 65 years (range, 51-77 years) and a mean follow-up of 47 months (range, 24-66 months). The WOMAC score in the harvested thigh differed by 0.8% from that in the contralateral thigh (P = .002). The mean PSAQ score differed by 6 points from the minimum PSAQ score (P < .001). Overall, 95% of the patients indicated that they would undergo the same surgery again and that the shoulder outcome compensated for the thigh symptoms. There was no significant association between the presence of residual thigh symptoms and the willingness to undergo the same surgery again (P = .354). The mean VAS score in the harvested thigh was 0.6 (range, 0-5). There was no significant difference in the average WOMAC score or VAS score between groups (P = .684 and P = .148, respectively).Conclusion:Despite the proportion of residual symptoms, the associated functional effects were small and not clinically significant, and the vast majority of patients were accepting of the harvest symptoms given the improvement in shoulder function.

Comparison of Cosmetic Results in Children >10 Years Old Undergoing Open, Laparoscopic or Robotic-Assisted Pyeloplasty: A Multicentric Study.

Our goal was to compare surgical scars assessed by a validated patient reported outcome questionnaire in children undergoing open (OP), laparoscopic (LP), or robotic-assisted (RALP) pyeloplasty. Our secondary aim was to assess the influence on the outcomes of variables such as gender or body mass index (BMI). We conducted an observational, cross-sectional, multicentric study of patients undergoing primary pyeloplasty between age 10 and 18 years at 5 tertiary Italian institutions during the period January 2010 to December 2019. Of 227 eligible patients 114 (50%) participated. OP was performed in 37 (32%), LP in 30 (26%) and RALP in 47 (41%), After a median (IQR) followup of 5.2 (2.3-7.8) years, scars were measured and assessed by a validated Patient Scar Assessment Questionnaire. Scores were compared among techniques and in accordance with several variables. The median length of the surgical scar at followup was significantly larger (p <0.0001) after OP (8.1 cm vs 1.8 cm for LP and 2.0 cm for RALP), where scar length correlated with BMI (p=0.04). Ninety patients (79%) had a Patient Scar Assessment Questionnaire score within the first quartile, the most favorable. During followup, 43 (38%) participants reported scar-related symptom. Symptoms were generally more common after OP (54% vs 30% for LP and 30% for RALP, p=0.06) and scar hyperesthesia was significantly more frequent after OP (p=0.01). Perception of the cosmetic outcomes in pre-adolescents and adolescents after pyeloplasty was generally good. LP achieved the best cosmetic results. OP was more commonly associated with scar-related symptoms and the size of the incision paralleled BMI.

MP37-20 COMPARISON OF CLINICAL OUTCOME, SURGICAL INVASIVENESS, AND COSMETIC RESULTS OF CONVENTIONAL LAPAROSCOPIC SURGERY AND REDUCED-PORT SURGERY FOR LIVING DONOR NEPHRECTOMY

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-20 COMPARISON OF CLINICAL OUTCOME, SURGICAL INVASIVENESS, AND COSMETIC RESULTS OF CONVENTIONAL LAPAROSCOPIC SURGERY AND REDUCED-PORT SURGERY FOR LIVING DONOR NEPHRECTOMY Mitsuru Saito, Shintaro Narita, Kazuyuki Numakura, Taketoshi Nara, Atsushi Koizumi, Ryohei Yamamoto, Soki Kashima, Shigeru Satoh, and Tomonori Habuchi Mitsuru SaitoMitsuru Saito More articles by this author , Shintaro NaritaShintaro Narita More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Taketoshi NaraTaketoshi Nara More articles by this author , Atsushi KoizumiAtsushi Koizumi More articles by this author , Ryohei YamamotoRyohei Yamamoto More articles by this author , Soki KashimaSoki Kashima More articles by this author , Shigeru SatohShigeru Satoh More articles by this author , and Tomonori HabuchiTomonori Habuchi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Reduced-port surgery (RPS) for living donor nephrectomy (LDN) is challenging. Whether RPS is less invasive than conventional laparoscopic surgery (CLS) using several ports is unclear. LDN is an optimal model for evaluating surgical invasiveness by measurement of circulating inflammatory cytokine levels, because renal transplant donors are not affected by disease status. In this study, we compared the clinical outcome, surgical invasiveness, and cosmetic results of CLS and RPS for LDN. METHODS: We enrolled 137 donors (the CLS group; 64, and the RPS group; 73) who underwent LDN in our hospital. The RPS group included 41 donors undergoing single-port surgery (SPS) and 32 donors undergoing surgery through a single port plus one additional 5-mm port. Evaluation of both surgical techniques included comparison of conventional clinical parameters and preoperative, immediate postoperative, and 1-day postoperative levels of the following circulating inflammatory cytokines; tumor necrosis factor (TNF)-α, interleukin (IL)-1b, IL-6, IL-8, IL-10, and IL-12p70. More than 1 year after surgery, cosmetic results were assessed for all donors by the Patient Scar Assessment Questionnaire (PSAQ). RESULTS: The frequency of performance of right nephrectomy was significantly lower in the RPS group than in the CLS group (6/64 vs. 1/73, p=0.03). Other clinical parameters in the RPS group, including the frequency of surgical complications and incidence of delayed graft function, were comparable to those in the CLS group. The immediate and 1-day postoperative mean serum IL-10 levels were significantly higher in the CLS group than in the RPS group (p<0.001 for both days). The 1-day postoperative mean serum TNF-α (p=0.02) and IL-8 (p=0.01) levels were also significantly higher in the CLS group than in the RPS group. The mean serum IL-10, TNF-α, and IL-8 levels were not associated with IL-6 levels, duration of surgery, or estimated intraoperative blood loss. Among young and middle-aged women, PSAQ scores indicated that donors undergoing RPS were significantly more satisfied with the cosmetic results than were donors undergoing CLS. CONCLUSIONS: There were no significant differences between the results of the two surgical techniques for LDN in conventional clinical parameters related to surgical invasiveness. Although the inflammatory cytokine response suggested that RPS was less invasive than CLS, the clinical outcome indicates that the two techniques were equally effective as minimally invasive surgeries. Young and middle-aged woman donors were more satisfied with the cosmetic results of RPS than with those of CLS. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e654-e654 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mitsuru Saito More articles by this author Shintaro Narita More articles by this author Kazuyuki Numakura More articles by this author Taketoshi Nara More articles by this author Atsushi Koizumi More articles by this author Ryohei Yamamoto More articles by this author Soki Kashima More articles by this author Shigeru Satoh More articles by this author Tomonori Habuchi More articles by this author Expand All Advertisement Loading ...

Suprapubic-assisted laparoendoscopic single-site surgery versus standard laparoscopic nephrectomy: A propensity score-based analysis.

To compare suprapubic-assisted laparoendoscopic single-site surgery nephrectomy with standard laparoscopic nephrectomy. A retrospective case-control study comparing three surgeons' experience with 122 suprapubic-assisted laparoendoscopic single-site surgery nephrectomy and 107 standard laparoscopic nephrectomy was carried out. Operative time, estimated blood loss, intraoperative complications, intraoperative conversion, postoperative bowel recovery, postoperative analgesics, postoperative visual analog pain scale score, postoperative length of stay, days before going back to work, postoperative complications and Patient Scar Assessment Questionnaire were compared after propensity score matching. A total of 97 matched pairs were obtained after propensity score matching. There were no statistically significant differences between the suprapubic-assisted laparoendoscopic single-site surgery nephrectomy and standard laparoscopic nephrectomy groups with respect to operative time, estimated blood loss, intraoperative complications, intraoperative conversion, postoperative bowel recovery, length of stay and postoperative complications. Suprapubic-assisted laparoendoscopic single-site surgery nephrectomy group had decreased postoperative analgesics (20.9 vs 23.5, P=0.04), visual analog pain scale score at 24h (4.28 vs 5.28, P=0.000), visual analog pain scale score at discharge (1.01 vs 1.47, P=0.000), days before going back to work (28.4 vs 31.9, P=0.000) and Patient Scar Assessment Questionnaire score (34.0 vs 42.0, P=0.000), compared with the standard laparoscopic nephrectomy group. Suprapubic-assisted laparoendoscopic single-site surgery nephrectomy and standard laparoscopic nephrectomy are equivalent in terms of the safety and efficacy. However, suprapubic-assisted laparoendoscopic single-site surgery nephrectomy confers less postoperative pain, fewer days before going back to work and better cosmetic result when compared with standard laparoscopic nephrectomy.

Laparoscopic-assisted versus open total pancreatectomy and islet autotransplantation: A case-matched study of pediatric patients

BackgroundTotal Pancreatectomy and Islet Autotransplantation (TPIAT) are a potential treatment for children with severe, refractory chronic pancreatitis. A laparoscopic-assisted approach provides a smaller incision and excellent visualization of the distal pancreas and spleen during resection. A minimally-invasive approach has proven advantageous for other pediatric procedures, but its value is unknown for this rare operation. This retrospective review compares outcomes between patients undergoing laparoscopic-assisted versus open TPIAT. Study designChildren (n = 21) receiving laparoscopic-assisted TPIAT from 2013 to 2015 and children (n = 21) receiving open TPIAT from 2011 to 2015 were matched based on age, gender, symptom duration, previous interventions, and pancreatic fibrosis scores. Data reviewed included postoperative complications, operative time, estimated blood loss (EBL), intraoperative blood transfusions, number of islet equivalents (IEQ)/kg transplanted, hospital length-of-stay, graft function, narcotic use, and Patient Scar Assessment Questionnaire scores. Between-group differences were compared using Fisher's exact, Chi-square, and T-tests. ResultsSurgical complications were similar between surgical groups (p = 0.35) and included wound complications (n = 11), chyle leak (n = 7), bowel obstruction (n = 5), bile leak (n = 3), gastrointestinal bleed (n = 2), and pneumonia (n = 1). There were no significant differences in operative time (p = 0.18), EBL (p = 0.96), blood transfusions (p = 0.34), IEQ/kg transplanted (p = 0.15), and hospital length-of-stay (p = 0.66). Insulin and opioid use was similar except for a slightly higher use of opioids (n = 4) at 2 years in the laparoscopic group. Patient surgical scar satisfaction was similar between groups (p = 0.26). ConclusionsOutcomes for laparoscopic-assisted TPIAT appear comparable to open TPIAT. In children, a minimally-invasive approach does not compromise safety, effectiveness, or operative efficiency and may be used based on surgeon and patient preference.

Health-Related Quality of Life and Cosmesis After Thyroidectomy: Long-Term Outcomes.

Health-related quality of life (HRQoL) after thyroidectomy has been recently reported with conflicting conclusions. In this study, we assess HRQoL and neck scar cosmesis of thyroid patients several years after thyroidectomy for benign and malignant pathology. Three hundred and thirty patients who underwent thyroidectomy between 2000 and 2010 answered the SF-36 Health Survey and Patient Scar Assessment Questionnaire (PSAQ) in 2010 and at the end of 2018. Changes in the SF-36 and PSAQ scores were analyzed taking into account various demographic, surgical and medical characteristics of the patients. Patients reported worse SF-36 scores after 8.5years, in scales of physical functioning (p < 0.001), social role functioning (p = 0.002), bodily pain (p = 0.001) and general health perceptions (p < 0.001). Interestingly enough, there were no significant changes in scales of physical role functioning (p = 0.304), mental health (p = 0.681), emotional role functioning (p = 0.903) and vitality (p = 0.121). Multivariate analysis showed that several chronic diseases were related to worse HRQoL scores. On the other hand, PSAQ appearance, symptoms and consciousness scores improved during this period (p < 0.001). In the long term, patients undergoing thyroidectomy do not show worse HRQoL outcomes in terms of mental health, emotional functioning and vitality, whereas scar cosmesis perception is improved. They show deteriorated outcomes in terms of physical, social functioning and bodily pain, which is mainly related to specific chronic diseases that are common to the aging person.

Mini-laparoscopic pyeloplasty in adults: Functional and cosmetic results.

The study objective was toevaluate thesafety and efficacyof mini-laparoscopic pyeloplasty (mLP) in an adult population and to demonstrate the functional and cosmetic results. Data for 29 patients (19 men and 10 women) undergoing mLP for ureteropelvic junction obstruction (UPJO) from May 2014 to December 2016 in Turkey were collected in this prospective study. Inclusion criteria were age ? 18 years, body mass index (BMI) ? 30 kg/m2 and primary UPJO, and no previous surgery on the affected kidney or previous abdominal surgery. Postoperative Visual Analogue Scale scores and the Patient Scar Assessment Questionnaire (PSAQ) were used. Demographic data, perioperative parameters, complications, and postoperative functional and cosmetic results were recorded. All statistical analyses were done by SPSS software. P value of <05 was considered statistically significant. Twenty-nine adults with a mean age of 29.4 ± 10.2 years (19-38 years) were included. The patients' mean BMI was 22.4 ± 4.3 kg/m2 (a range of 16-29 kg/m2). The procedures were performed using three ports (one 5 mm port for the camera and two 3 mm ports). Mean operative time was 119 ± 28.5 minutes (85-144 minutes). Major complications were not observed, as per the Clavien-Dindo classification of surgical complications (grades IV-V). The mean VAS score was 1.2 ± 0.2 points. Functional obstruction was reported in one patient on renal scintigraphy at 12 months postoperatively. The success rate of mLP was 97%. The minimum and maximum PSAQ scores at month 3 postoperatively were 24 and 86, respectively. All the patients were satisfied with the intervention and with their cosmetic results. mLP is a safe, effective and feasible treatment method for UPJO in adult patients. This treatment modality offers excellent cosmetic and functional results following treatment for UPJO.

Prospective randomized comparison of transumbilical two-port laparoscopic and conventional laparoscopic varicocele ligation

We have established a novel method named transumbilical two-port laparoscopic varicocele ligation (TTLVL) for varicocele, which is still needed to evaluate. In this study, 90 patients with left idiopathic symptomatic varicoceles of grades II–III according to the Dubin grading system were randomly assigned to TTLVL (n = 45) and conventional laparoscopic varicocele ligation (CLVL) (n = 45). The demographic, intraoperative, postoperative, and follow-up data were recorded and compared between the two groups. All the procedures in the two groups were completed successfully with no intraoperative complications and no conversions to open surgery. No significant difference was found in the operative time, resuming ambulation, bowel recovery, postoperative hospital stay, and postoperative resolution of scrotal pain between the two groups (P > 0.05). However, the postoperative mean visual analog pain scale scores for TTLVL group were all less at 24 h, 48 h, 72 h, and 7 days postoperatively compared to CLVL (P = 0.001, 0.010, 0.006, and 0.027, respectively). The mean patient scar assessment questionnaire score in postoperative month 3 was 29.7 for TTLVL group compared with 32.1 for CLVL group (P < 0.001). There was no testicular atrophy observed in both groups during the follow-up period. The study shows that TTLVL is a safe, feasible, and effective minimally invasive surgical alternative to CLVL for the treatment of varicocele. Compared with CLVL, TTLVL may decrease postoperative pain and improve the cosmetic outcomes.

How do patients score cosmesis after laparoscopic natural orifice specimen extraction colectomy?

Laparoscopic colorectal resection results in improved cosmetic outcome and better presumed body image. Laparoscopic NOSE colectomy omits an incision for specimen extraction and is supposed to further improve postoperative cosmesis. This study aimed to assess the cosmetic benefit. Forty-nine patients who underwent a NOSE colectomy for bowel endometriosis from September 2009 to September 2013 were matched for age, American Society of Anesthesiologists (ASA) grade and body mass index (BMI) with patients who underwent a conventional laparoscopic colectomy for the same indication. Patients were asked to complete a questionnaire consisting of a body scale and a cosmetic scale and the Patient Scar Assessment Questionnaire (PSAQ) including five subscales (appearance, symptoms, scar consciousness, satisfaction with appearance and satisfaction with symptoms). Patient demographics were similar between both groups. Patients were assessed at a median postoperative follow-up of 41months in the NOSE colectomy group and 35months in the conventional resection group. The median body image questionnaire score was 15 for NOSE colectomy and 18 for conventional resection (P=0.027). The respective median PSAQ scores were 56 and 71 (P=0.002). There was a good relationship between the PSAQ score and the body image questionnaire (Spearman correlation coefficient 0.82). Depending on the scoring system used, the cosmetic outcome may be better after NOSE colectomy than conventional laparoscopy in patients having surgery for endometriosis. The comprehensive body image questionnaire, being shorter and easier to use, could be a valid tool for assessing cosmesis after NOSE procedures.

Mini-retroperitoneoscopic Adrenalectomy: Our Experience After 50 Procedures

To present our experience with retroperitoneoscopic adrenalectomy using 3-mm instruments (mini-rA) for adrenal tumors. From March 2009 to May 2013, patients with adrenal tumors <6 cm in size and body mass index ≤ 35 were involved in this prospective study and underwent mini-rA performed by 3-mm instruments. Demographic, endocrine and perioperative data, and cosmetic results (using Patient Scar Assessment Questionnaire and Scoring System) were recorded and analyzed. Fifty procedures were performed in 48 patients. All procedures were performed with neither conversion to open surgery nor reoperation or mortality. Median operative time and blood loss were 90 minutes (range, 45-210 minutes) and 50 mL (range, 20-210 mL), respectively. Only 1 intraoperative complication (2%) was recorded. Conversion to conventional laparoscopy was needed in 4 procedures (8%). Postoperative complications were recorded in 6 cases (Clavien grade ≤ 2). No differences were recorded in terms of perioperative variables when comparing procedures performed in patients having secreting tumors (n = 18) with other ones (n = 32). On the contrary, procedures performed in patients having benign lesions (n = 41) had significantly lower operative times and complications with respect to those performed in patients with malignant lesions (n = 9). Median Patient Scar Assessment Questionnaire score was 30 (minimum score 28 = the best result; maximum score = 112, the worst result). In selected population, mini-rA is a feasible, safe, and effective technique in the treatment of adrenal masses <6 cm in size, offering objectively proven excellent patients' satisfaction with symptoms and cosmesis. Significant experience before embarking in this kind of surgery is recommended.

Comparison of satisfaction after direct browplasty in Asian patients with and without brow tattoo

ObjectiveTo determine patient-based scar assessment after direct browplasty for correction of brow ptosis between Asian female patients with and without brow tattoos. DesignA retrospective study with questionnaire via telephone interview. ParticipantsA total of 30 female Asian patients underwent direct browplasty from January 2008 to December 2011. MethodsThe Patient Scar Assessment Questionnaire (PSAQ) with 5 subscales including appearance, symptoms, consciousness, satisfaction with appearance, and satisfaction with symptoms was used at least 6 months after surgery in patients who underwent direct browplasty. PSAQ scores were compared between Group A (15 cases with brow tattoo lines) and Group B (15 cases without brow tattoo). A lower score indicates a favourable cosmetic outcome. ResultsOf the subscales of PSAQ, only “satisfaction with appearance” was significantly lower in Group A (1.4 ± 0.5) than in Group B (2.0 ± 1.0; p = 0.039). Mean scores of appearance, symptoms, satisfaction with symptoms, and overall scores were not different between 2 groups. ConclusionsAccording to the PSAQ, mean scores of appearance, symptoms, and consciousness regarding surgical scar after direct browplasty were relatively low. Asian patients who underwent direct browplasty were generally satisfied with overall appearance and comfort of their scar regardless of brow tattoo lines, despite the statistical difference in their satisfaction with appearance.

Standard vs mini‐laparoscopic pyeloplasty: perioperative outcomes and cosmetic results

Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? New techniques and instrumentation in laparoscopy including the use of 'single-port' devices and natural orifice transluminal endoscopic surgery have been proposed to reduce the invasiveness of these procedures. The introduction of small laparoscopic instruments (<3 mm) continues to further the field. To date, mini-laparoscopic instruments have been used in many urological procedures, e.g. pyeloplasty in the paediatric population. However, data of pure mini-laparoscopic pyeloplasty (mLP) for the treatment of pelvi-ureteric junction obstruction in the adult population are lacking. In a selected adult population mLP is feasible and safe. Perioperative and 1-year functional results are comparable with those of standard LP, while cosmetic results of mLP are more appreciated by the patients. To evaluate perioperative and cosmetic results after pure mini-laparoscopic pyeloplasty (mLP) compared with standard LP (sLP) in an adult population. From April 2009 to June 2010, 12 patients underwent mLP for pelvi-ureteric junction (PUJ) obstruction (PUJO). For comparison, 24 patients that had previously undergone sLP were pooled from our institutional database. All patients were assessed preoperatively with physical examination, abdominal ultrasonography, intravenous urography or computed tomography and renal scintigraphy (RS). In all cases, an Anderson-Hynes transperitoneal approach was used. After surgery, cosmetic results were assessed using a Patient Scar Assessment Questionnaire (PSAQ), and RS measured reconstructive success at 1-year after LP. Demographic and perioperative variables were recorded. Groups were compared using chi-squared and Wilcoxon-Mann-Whitney tests (P < 0.05 was considered significant). Baseline characteristics were similar between the groups. There were no differences in operative duration or blood loss. One mLP required conversion to sLP due to minor bleeding. Analgesic consumption and the pain visual analogue scale scores were not significantly different between the sLP and mLP cohorts. The average postoperative hospital stay for the mLP group was significantly shorter than that for the sLP group (P = 0.024). Complication and success rates between the groups were not significantly different. PSAQ scores showed that mLP patients were significantly more satisfied with their cosmetic result. mLP appears to be safe, feasible and effective in the treatment of PUJOs. Cosmetically, mLP is better than sLP.

The Patient Scar Assessment Questionnaire: A Reliable and Valid Patient-Reported Outcomes Measure for Linear Scars

There is a lack of rigorously validated patient-based outcomes measures of scarring. The aim of this study was to construct such a scale and demonstrate reliability and validity by applying the scale in a wide range of scarring samples. The Patient Scar Assessment Questionnaire with five subscales (i.e., Appearance, Symptoms, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms) was constructed using multiple categorical response items. The Patient Scar Assessment Questionnaire was applied to various surgical samples (total scar assessments n = 667) at months 3, 6, and 12 after surgery (and preoperatively in the scar revision group) and tested for internal consistency, test-retest reliability, convergent validity, known group differences, and sensitivity, against widely accepted criteria from psychometric measurement science. Subscales showed high internal consistency (Cronbach alpha, 0.73 to 0.93), except the Symptoms subscale. Test-retest reliability was high across all subscales (intraclass correlation coefficient, 0.74 to 0.87) across all groups except the scar revision group. Change in Patient Scar Assessment Questionnaire scores was significant between months 3 and 6 postoperatively (p < 0.001) and subscales demonstrated known group differences (p < 0.001). Convergent validity was demonstrated by significant moderate correlations with various measures of similar constructs (r = 0.26 to 0.61, p < 0.001). The Patient Scar Assessment Questionnaire is a reliable and valid measure of the patient's perception of scarring, although the Symptoms subscale requires further refinement. Subscales can be used independently of each other to allow assessment of scar change in specific domains.