Patient Scar Assessment Questionnaire Research Articles

The Effects of Aloe Vera Cream on the Alar Scar in Rhinoplasty, A Randomized Double-Blind Controlled Trial.

Many studies have been done on the use of aloe vera in wound healing, but fewer studies were done on the influence of this material on the reduction of the alar scar. Therefore, we evaluated the effect of a newly made aloe vera cream on alar wound healing after rhinoplasty. This was a randomized, double-arm, parallel-group, double-blind controlled trial and was done from June 2021 to February 2022. External wedge resection was done for all patients. The patients were randomly assigned to receive aloe vera cream (n=31) (intervention group) or Face Doux cream (comparison group) (n = 29). A pharmacist prepared the aloe vera cream. The primary outcome measure was the wound scar status which was assessed by two Questionnaires, including the mean Patient Scar Assessment Questionnaire (PSAQ) and Vancouver Scar Scale (VSS). Randomization and Blinding were done. The mean PSAQ was significantly lower in group A after two weeks (26.9 versus 31.5, P<0.001), after two months (15.7 versus 19.6, P=0.04), and six months follow-up (8.8 versus 11.8, P=0.005). The mean VSS was significantly lower in group A after two weeks (5.6 versus 7.1, P=0.001), after two months (3.5 versus 4.9, P=0.002), and six months (1.2 versus 2.7, P<0.001). Repeated measurement analysis showed that both interventions significantly affected PSAQ and VSS. Although both interventions had a significant effect on PSAQ and VSS, compared to Face Duox, the topical use of Aloe Vera cream significantly reduced scar formation after alar resection, both statistically and clinically.

A prospective study to assess cervical scar satisfaction following conventional open thyroidectomy for thyroid cancer.

Conventional open thyroidectomy (COT) remains a common method of thyroidectomy in many parts of the world for various reasons. In this prospective (cross-sectional) study, we evaluated the scar satisfaction among patients and surgeons following COT using the Patient and Observer Scar Assessment Scale (POSAS) and the Patient Scar Assessment Questionnaire (PSAQ). A total of 116 patients were included. The median age of the patients was 44years and the majority were women. The median scar length overall was 12.2cm. On POSAS, the median score for surgeon 1 was 1 (range 1-5), for surgeon 2, it was 2 (range 1-6), and for the patient, it was 1 (range 1-6) suggesting good scar satisfaction. The patient's response in the PSAQ was also echoing similar outcomes with scar satisfaction. Overall, both the patients and the surgeons seem to be satisfied with the overall scar appearance following COT despite the scar length.

The Effectiveness of 595-nm Pulsed Dye Laser for the Treatment of Bilateral Cleft-Lip Scars in Asian Patients: A 6-Month Prospective, Randomized, Self-Controlled Trial.

Objective: This study is the first prospective within-patient self-controlled research seeking to investigate the safety and efficacy of 595 nm pulsed-dye laser (PDL) for the treatment of cleft-lip scars. Approach: This prospective, randomized, self-controlled study is based on the clinical records of the patients who received laser-assisted treatment due to bilateral cleft-lip scars. The bilateral scars were randomly assigned to the 595 nm PDL group with five consecutive sessions at 2-week intervals or control group in a blinded manner of evaluators, with subsequent follow-up for 6 months after the final treatment. Clinical efficacy and safety outcomes were evaluated by Vancouver Scar Scale (VSS), Patient Scar Assessment Questionnaire (PSAQ), and other objective evaluations. Results: A total of 18 patients were included. The 595 nm PDL-treated sides showed statistically significant improvement in VSS after treatment at follow-up compared with the baseline (p < 0.05). Interestingly, the 595 nm-PDL-treated side achieved significantly better improvement in scar pigmentation and pliability (p < 0.05). Though there was statistically significant difference between two groups (p < 0.05), the gap in overall PSAQ is not obvious. And comparison by area and coloring evaluation (E/M index) also suggests that the responses of scars to treatment by PDL were slightly improved (p < 0.05). Innovation and Conclusion: It is the first time to apply the 595nm PDL for cleft-lip scars. It would be a better choice for the early treatment of red scar with proliferative tendency after cleft-lip surgery.

Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea.

This study was performed to evaluate the safety and feasibility of skin adhesives and to compare postoperative and cosmetic outcomes after wound closure in single-port laparoscopic appendectomy (SPLA) between skin adhesives and steri-strips. This was a single-center retrospective study. We included 22 and 47 patients in whom skin adhesive and steri-strips were used respectively, for skin closure after subcuticular suturing in SPLA between August 2014 and 2020. The patient scar assessment questionnaire (PSAQ) was completed postoperatively to assess postoperative cosmetic outcomes. On the postoperative day, patients in whom skin adhesive was used had significantly lower numeric rating scores than in whom steri-strips were used (2.8 ± 0.8 vs. 3.9 ± 0.8, p < 0.001). The frequency of analgesic administration within 24 hours and between 24 and 48 hours after surgery was significantly lower in the skin adhesive group compared to the wound closure strip group (1.4 ± 0.8 vs. 2.7 ± 1.2, p = 0.013 and 0.2 ± 0.4 vs. 0.7 ± 0.9, p = 0.002, respectively). In the PSAQ, "satisfaction with appearance" and "satisfaction with symptoms" subitem scores were significantly lower in patients in whom skin adhesive was used (11.3 ± 3.0 vs. 15.1 ± 4.5, p = 0.006 and 6.5 ± 1.8 vs. 9.5 ± 3.3, p = 0.003), whereas, "appearance" and "consciousness" subitems revealed no statistically significant differences between the groups. Liquid skin adhesive closures seem to be safe and feasible and cause less postoperative pain, resulting in greater patient satisfaction with postoperative scars than wound closure strip closure after subcuticular suturing in SPLA.

Short-term and long-term outcomes of intracorporeal anastomosis in laparoscopic segmental left colectomy for splenic flexure cancer - a multicenter retrospective cohort study of 342 cases.

While intracorporeal anastomosis (IA) has been widely used in totally laparoscopic right colectomy, its application in laparoscopic segmental left colectomy for splenic flexure cancer remains underexplored, particularly in large-scale studies with long-term outcomes. This research aims to assess the technical feasibility and oncological efficacy of IA in treating colonic splenic flexure carcinoma, drawing insights from both short-term and long-term outcomes of a retrospective cohort. A retrospective analysis was conducted on 342 patients diagnosed with colonic splenic flexure carcinoma in three Chinese medical centers. These patients underwent laparoscopic segmental left colectomy between December 2014 and December 2019 across three medical institutions. Comprehensive data encompassing demographics, disease features, pathological characteristics, operative details, and both short-term and long-term outcomes were gathered and scrutinized. Using propensity scores, each patient from the IA cohort was paired with a counterpart from the extracorporeal anastomosis (EA) cohort. IA was performed on 129 patients, while 213 underwent EA. Post-propensity score matching resulted in 129 matched pairs. After matching, many baseline characteristics were balanced. The IA cohort exhibited several advantages, including shorter incision lengths ( P <0.001) and more extensive proximal and distal resection margins ( P =0.003, P <0.001). Additionally, the IA method facilitated a more rapid postoperative recovery as indicated by quicker return of bowel movements (resumption of passing flatus [2.7 (1.0-7.0) days vs. 3.3 (2.0-8.0) days, P <0.001] and defecation [3.7 (1.0-9.0)] days vs. 4.5 (2.0-9.0) days, P <0.001]), faster discharges [6.6 (3.0-15.0) days vs. 8.3 (5.0-20.0) days, P <0.001], and decreased need for rescue analgesics ( P <0.001). The rate of postoperative complications, as rated by the Clavien-Dindo classification, remained consistent across both techniques ( P =0.087). Furthermore, the cosmetic outcome rated by Patient Scar Assessment Questionnaire and Scoring System (PSAQ) was markedly superior in the IA group ( P <0.001). Both approaches demonstrated equivalent 5-year overall (82.7% vs. 82.1%, P =0.419) and disease-free survival (80.9% vs. 78.1%, P =0.476). Subsequent stratification analysis revealed that IA achieved comparable 5-year overall (80.7% vs. 82.0%, P =0.647) and disease-free survival (78.1% vs. 76.4%, P =0.734) in patients with locally advanced colon cancer. Employing IA for laparoscopic segmental left colectomy in cases of splenic flexure carcinoma is not only safe but also offers enhanced cosmetic results and expedited postoperative recovery. Oncologically speaking, IA in left segmental colectomy for splenic flexure carcinoma can yield therapeutic outcomes comparable to those of EA, even in patients with locally advanced colon cancer.

A prospective study on single-port versus multiport patient-reported surgical outcomes.

We sought to determine potential patient reported advantages of the da Vinci single-port (SP) robotic system for urological procedures compared with the previous model, the da Vinci multiport (MP) system. The SP model utilizes a single 30 to 40 mm incision rather than multiple 5 to 22 mm incisions. This project aims to prospectively investigate the impact of the novel SP system on patient reported cosmetic and psychometric surgical outcomes. We conducted a prospective study of patients who underwent uro-oncologic surgery by three urologists at the University of Illinois Chicago from April to November 2021. Study participants completed a Patient Scar Assessment Questionnaire 20 and 90 days post-procedure. The Patient Scar Assessment Questionnaire is a reliable measure of surgical scars that includes five subscales: Appearance, Symptoms, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms. Higher scores represented worse reported outcomes. On Postoperative Day 20, there were 77 responses (53 SP and 24 MP). Patients receiving SP procedures reported more favourable outcomes in terms of appearance, symptoms, consciousness, and pain medication. On Day 90, there were 37 responses (24 SP and 13 MP). Patients receiving SP procedures reported more favourable outcomes in terms of appearance. No significant differences were seen on Day 90 in terms of pain, medication, symptoms, consciousness, or satisfaction. This study demonstrates the superiority of the SP in patient reported cosmetic and pain outcomes on short- and long-term follow-up after uro-oncological surgical procedures. Symptomatic and cosmetic advantages are present at the 20 day follow-up, with better scar appearance being significant 90 days after surgery.

Patient's Scar Satisfaction after Conventional Thyroidectomy for Differentiated Thyroid Cancer.

Differentiated thyroid carcinoma (DTC) is the most frequent endocrine neoplasm. Its treatment is based on surgery with consequent impact on patients' quality of life (QoL) and aesthetic implication. The aim of the present study is to assess scar satisfaction in patients affected by DTC who underwent total or partial thyroidectomy. A comparison was also made between scar satisfaction with different subcuticular suture. Validated questionnaires have been employed during a 3-month follow-up: Patient and Observer Scar Assessment Scale (POSAS) and the Patient Scar Assessment Questionnaire (PSAQ). Eventually, the impact of thyroid cancer on QoL of patients was performed in the studied population employing the Thyroid-related patient-reported outcome questionnaire (ThyPRO) and European Organisation for Research Additionally, Treatment of Cancer-Quality of Life questionnaire-C30 (EORTC QLQ-C30). It was conducted in a single center observational study considering 74 patients respecting inclusion criteria. Overall scar satisfaction was found to improve during follow-up, reaching the best scores at 3 months from surgery. Subcuticular suture does not seem to influence the scar satisfaction. In our study male patients seem to be more satisfied, on the other hand age does not seem to influence satisfaction. Overall, the ThyPRO questionnaire and EORTC QLQ-C30 scores did not statistically differ between preoperative and postoperative suggesting a small impact of DTC in QoL.

A prospective randomized controlled study comparing patient-reported scar evaluation of single-port versus multiport laparoscopic appendectomy for acute appendicitis.

This study aimed to compare the postoperative outcomes and patient-surveyed scar assessments of single-port laparoscopic appendectomy (SPLA) with the outcomes of multiport laparoscopic appendectomy (MPLA). Between August 2014 and November 2017, the prospective randomized study comprised 98 patients diagnosed with acute appendicitis and indicated for surgery. Fifty-one patients had MPLA and 47 patients received SPLA. The primary endpoint was the total score of Patient Scar Assessment Questionnaire (PSAQ) administered to patients 6 weeks after surgery. SPLA involved a shorter median operative time than MPLA (47.5 minutes vs. 60.0 minutes, p = 0.02). There were no apparent differences in the time before diet tolerance, length of hospital stay, and postoperative complication. SPLA patients had shorter total incision length (2.0 cm vs. 2.5 cm, p < 0.01) and required fewer analgesics on the day of surgery than MPLA patients (p = 0.011). The PSAQ favored the SPLA approach, revealing significant differences in total score (48 vs. 55, p = 0.026), appearance (15 vs. 18, p = 0.002), and consciousness (8 vs. 10, p = 0.005), while satisfaction with appearance and symptoms scale did not (p = 0.162 and p = 0.690, respectively). The postoperative scar evaluated by the patient was better with SPLA than with MPLA, and patient satisfaction with the scar was comparable between the two techniques.

Brazilian Portuguese version of the Patient Scar Assessment Questionnaire

A Revista Brasileira de Cirurgia Plástica é o órgão oficial de divulgação da Sociedade Brasileira de Cirurgia Plástica (SBCP), tem como objetivo registrar a produção científica em Cirurgia Plástica, fomentar o estudo, aperfeiçoamento e atualização dos profissionais da especialidade.

Single-port Versus Multi-port Robotic-assisted Procedures From the Patient’s Perspective: A Retrospective Cohort Study

The da Vinci SP® single-port system, differently from prior platforms, utilizes a single 2.5 cm incision to accommodate 1 flexible camera and 3 articulated robotic arms. Potential advantages include shorter hospitalization, improved cosmesis, and reduced postoperative pain. This project investigates the impact of the novel single-port system on cosmetic and psychometric patient assessment. The Patient Scar Assessment Questionnaire (a validated patient-reported outcomes measure for surgical scar) has been administered retrospectively to patients who underwent either an SP or Xi® urological procedure at a single center. Four domains were assessed: Appearance, Consciousness, Satisfaction With Appearance, and Satisfaction With Symptoms. Higher scores represent worse reported outcomes. Compared to 78 Xi procedure recipients (mean 15.28), 104 SP procedure recipients (mean 13.84) reported significantly better cosmetic scar appearance U(NSP=104, NMP=78) = 3,739 (P = .007) where U is the difference between the 2 rank totals, and NSP and NMP represent the number of single-port and multi-port procedure recipient respondents, respectively. Similarly, the SP cohort (mean 8.80) compared to the Xi group (mean 9.87) demonstrated significantly better consciousness of their surgical scar, U(NSP=104, NMP=78) = 3,329 (P = .045), and higher satisfaction with the cosmetic appearance of their surgical scar, U(NSP=103, NMP=78) = 3,232 (P = .022), with the SP group (mean 11.35) attaining better scores than the Xi group (mean 12.54). No significant difference was found for "Satisfaction With Symptoms," U(NSP=103, NMP=78) = 3,969 (P = .88), despite the SP group (mean 6.58) attaining lower scores than the Xi group (mean 6.74). This study demonstrates patients' favorable perception of SP versus XI surgery in terms of aesthetic outcomes. An ongoing study is investigating the relationship between cosmetic satisfaction and length of stay, postoperative pain, and narcotic use.

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.

The Effect of Stromal Vascular Fraction on Scar Formation of Transverse Rectus Abdominis Muscle Flap Donor Sites: A Pilot Study

Background: Stromal vascular fraction (SVF), which plays a substantial role in wound healing, has been discussed in many recent studies concerning its positive effect on scar formation. Our study explored the effects of SVF on scar formation from partially-removed transverse rectus abdominis muscle (TRAM) flaps after inset.Methods: From December 2017 to May 2020, we enrolled 11 patients undergoing breast reconstruction performed by a single surgeon using the free TRAM flap. As a split-body, placebo-controlled study, SVF was subcutaneously injected into one side of the abdomen, and normal saline was injected into the other side of each patient. Scarring was evaluated using the Vancouver Scar Scale (VSS) and Patient Scar Assessment Questionnaire (PSAQ) at 1, 6, and 12 months after surgery, and histology was evaluated with immunofluorescence analysis at 6 months after surgery.Results: No statistically significant differences were noted in the total scores or subcategory score of the VSS and PSAQ between the test and control groups. Some patients showed more positive staining for alpha smooth muscle actin, collagen type I, and type III in the test group than in the control group. However, quantification of positively stained areas showed no statistically significant difference.Conclusion: Intraoperative SVF injection had no demonstrable clinical effect on scar quality. Histology with immunofluorescence analysis also failed to demonstrate any significant effect of SVF on scars at the microscopic level. Despite previous studies indicating the positive effects of SVF on scar quality, this pilot study questions its true effectiveness.

Sacrococcygeal teratomas: midline reconstruction improves cosmesis without compromising outcomes.

Several studies have addressed the long-term functional, psychosexual and psychosocial outcomes following sacrococcygeal teratoma (SCT) excision. It is well reported that the classical chevron incision and reconstruction can leave a cosmetically unsatisfactory result; however, there is little in the literature focussed on improving this outcome. In our institution the preference is to perform a midline reconstruction, where possible, this is felt to improve appearance without compromising the oncological or functional outcome. The aim of this study was to evaluate patient-perceived cosmetic outcomes of the midline reconstruction. All patients undergoing surgery for SCT between 2007 and 2020 were included in the study. Patient demographics, operation type, functional outcome and recurrence were all recorded. The primary outcome measure was patient/parent satisfaction with the cosmetic appearance. This was assessed using both qualitative and quantitative methodologies. Following ethical approval parents were asked questions from two existing validated patient outcome questionnaires: "Patient and Observer Scar Assessment Scale" (POSAS) v2.0 and the "Patient Scar Assessment Questionnaire". Thirty-two patients underwent surgery at our institution for SCT during the study period. Twenty-four had a posterior approach with midline reconstruction, two laparotomy and excision (excluded from this study) and six had a combined approach. Median follow-up was 35months (8.5-96months). There were no recurrences. 4/30 (13%) have persistent urological symptoms, and 1/30 (3%) has constipation requiring bowel management. Questionnaires were sent to 26/30 families with a 77% return rate. Median total score was 11 (7.4-17.5) on a 60-point scale (6, as normal skin, 60, worst imaginable scar). Twenty (95%) reported that the scar never affects the child's activities and 15 (71%) said they are "not at all" conscious of the scar. Scars can lead to an array of cosmetic, functional, and psychological consequences and as such consideration needs to be given to scarring following surgery for sacrococcygeal teratomas. This study demonstrates that a midline reconstruction produces a cosmetically favourable outcome. We, therefore, recommend where appropriate a midline reconstruction should be considered for SCT.

Rhomboid flap scar assessment: A patient reported outcome study. A case series

Introduction and importanceLocal skin flap techniques, including rhomboid flap, have been developed to reconstruct cutaneous defects. Rhomboid flap advantages include easy design, excellent contour, texture, thickness, color match, and long-term good cosmesis. There is no patient reported outcome study in literature detailing patients’ perception of appearance and satisfaction of scar appearance. MethodsWe studied 100 consecutive rhomboid flaps performed in 73 patients by a single surgeon. After at least one year from flap completion, a validated published Patient Scar Assessment Questionnaire (PSAQ) by Durani et al. was completed for each flap. ResultsThe median age was 73 years, with a range of 21 years–94 years. Gender breakdown was 65 flaps in males and 35 flaps in females. For appearance, there were significantly greater frequency of “very well-matched scar” patients compared to “well-matched scar” patients (p < 0.001). There were no “a little matched” or “poorly matched” patients. For satisfaction of appearance scores, there were significantly greater frequency of “very satisfied” patients compared to “satisfied” patients (p < 0.001). There were no “dissatisfied” or “very dissatisfied” patients. Although size of primary defect was not statistically significant (p 0.071), there was a trend towards better appearance scar match and scar satisfaction for smaller defects. Age was not statistically significant (p 0.086), there was a trend towards better appearance scar match and scar satisfaction among older patients. There was no significant difference in appearance match and satisfaction scores based on the gender (p 0.733). There were no post-operative complications. ConclusionsOur study confirms, in experienced hands, the long-term patient perception of well-matched scar appearance and scar satisfaction with rhomboid flap technique. A significantly greater frequency of patients were “very satisfied” than “satisfied”, with no “dissatisfied” patients. There was no statistically significant difference based on age, gender, and size of the primary defect.

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.

Patient and Observer Graded Rhinoplasty Scar Outcomes: A Randomized Controlled Trial of Fast Absorbing Versus Permanent Columellar Suture Closure.

Background: When performing an open rhinoplasty, surgeons commonly use nonabsorbable skin sutures to close the columellar incision. These are believed to minimize scarring. However, removal can be associated with patient discomfort and outcomes may not be superior to using absorbable sutures. Objective: To compare difference in scar appearance for columellar closure after rhinoplasty with absorbable and nonabsorbable sutures. Methods: We performed a prospective randomized control trial with 61 patients. Forty-one patients completed follow-up and were included in final analysis: 23 whose columellar incision was closed with absorbable sutures and 18 with nonabsorbable sutures. A blinded surgeon performed Stony Brook Evaluation Scale (SBES) and a patient performed Patient Scar Assessment Questionnaire (PSAQ) was completed for each suture type. Results: Our results did not reject the null hypothesis that there is no difference in SBES or PSAQ scores between absorbable and nonabsorbable suture types. Conclusions: No difference was detected in scar outcomes between absorbable and nonabsorbable sutures for closure of the columellar incision created during an open rhinoplasty as rated by both patients and blinded clinicians.

Technical Feasibility, Outcomes, and Patient SatisfactionAfter Needlescopic and Laparoscopic Bariatric Surgery: a Randomized Study.

Needlescopic instruments create a 3-mm incision and may result in less pain and superior cosmesis. There is limited understanding of the effectiveness of needlescopic instruments in patients with a body mass index (BMI) > 35 kg/m2. We report perioperative outcomes and perception of body image with use of needlescopic instruments after bariatric surgery. Laparoscopic bariatric procedures were performed on 30 adults at a single academic medical center from January to December 2017. Patients were randomized to conventional laparoscopy (LAP) or needlescopic (NEED) surgery. The Multidimensional Body-Self Relations Questionnaire (MBSRQ) and Patient Scar Assessment Questionnaire (PSAQ) were completed at 6 months and 1 year. Univariate analysis was performed on perioperative outcomes and survey scores. Surgery was completed on patients in the LAP group (N = 13) and compared to the NEED group (N = 17). The mean BMI was 41.4 kg/m2 LAP and 41.1 kg/m2 NEED. The most common procedure was Roux-en-Y gastric bypass (RYGB), with 13 RYGB in LAP and 12 RYGB in NEED (P = 0.76).The operative time was not significantly different between the LAP and the NEED group (209.5 ± 66.1 vs 181.9 ± 58.1 min, P = 0.48). There was no leak or mortality in the 30-day follow-up period. Within MBSRQ, the patient's appearance self-evaluation score was similar between LAP and NEED (2.5 ± 0.6 vs 2.4 ± 0.6, P = 0.61). Within PSAQ, the mean satisfaction score for incision appearance was also similar between LAP and NEED (16.1± 2.9 vs 15.4 ± 4.6, P = 0.85). Incision-related perceptions remained consistent at 6 months and 1 year after bariatric surgery. Needlescopic instruments are safe and a viable alternative to use during bariatric surgery. Appearance and perception of scar were similar between groups. Further studies with needlescopic instruments should include patients with a BMI > 35 kg/m2 and compare additional factors associated with body image.

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 ...

An evaluation of a ScarWork service for cancer survivors experiencing adverse effects of surgery and/or radiotherapy

IntroductionIn the UK, 68% of early stage cancer patients undergo surgical resection, which may result in troublesome physiological and psychosocial symptoms from scars associated with this curative- intent surgery. We evaluated a 12-month service offering ScarWork, a light-touch manual therapy, to improve our understanding of this novel intervention. MethodsA National Health Service (NHS) cancer centre offered eight ScarWork treatments to survivors who had undergone surgery (and/or radiotherapy) for breast, colorectal, gynaecological, head and neck cancers or melanoma. Outcome measures administered at beginning and end-of-treatment included the Patient Scar Assessment Questionnaire (PSAQ) and Measure Yourself Medical Outcome Profile (MYMOP). Patients could specify one or more scars. A semi-structured questionnaire administered at end-of-treatment collected patients’ impressions of ScarWork. ResultsNineteen patients, reporting 25 scars with a mean scar age of 4.2 years (range: 0.5-17 years) received a median of six ScarWork treatments (range: 0-12). PSAQ showed significant improvements for subscales Appearance, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms; symptom improvements included itching, frequency of discomfort, sensations of numbness and overall troublesomeness. Mean MYMOP profile score showed 1.8 (SE=0.3) points improvement on a 7-point scale, where change of ≥0.5-1.0 points is clinically significant. In written feedback, patients reported benefits including improved appearance, texture, mobility, wellbeing and acceptance of scars. No serious adverse events were reported. ConclusionsFeedback from this service assured funding for continued clinical activity. Valuable experience in administering outcome measures, especially PSAQ, was gained. This will facilitate improved data collection and analysis for future service development.