Original article
An objective device for measuring surface roughness of skin and scars

Presented in part at the Fifth Joint Meeting of the European Tissue Repair Society in Limoges, France, on August 25-29, 2009, and the 13th European Burns Association Congress in Lausanne, Switzerland, on September 2-5, 2009.
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Background

Scar formation remains a major clinical problem; therefore, various therapies have been developed to improve scar quality. To evaluate the effectiveness of these therapies, objective measurement tools are necessary. An appropriate, objective measuring instrument for assessment of surface roughness is not yet available in a clinical setting. The Phaseshift Rapid In Vivo Measurement of the Skin (PRIMOS) (GFMesstechnik GmbH, Teltow, Germany) could be such an instrument. This device noninvasively produces a 3-dimensional image of the skin microtopography and measures surface roughness.

Objective

The aim of this study was to investigate the reliability and validity of the PRIMOS for objective and quantitative measurement of surface roughness of skin and scars.

Methods

Three observers assessed skin and burn scars in 60 patients using the PRIMOS and a subjective scale, the Patient and Observer Scar Assessment Scale. Reliability was tested using the intraclass correlation of intraobserver and interobserver measurements. An intraclass correlation coefficient of 0.7 or greater was required for reliable results. To test validity, scores of the PRIMOS were compared with scores of the subjective scale (Pearson correlation). A Pearson correlation coefficient greater than 0.6 was considered a strong positive correlation.

Results

All 3 surface roughness parameters of the PRIMOS showed good intraobserver and interobserver reliability for skin and scars (intraclass correlation coefficient arithmetic mean of surface roughness > 0.85, mean of 5 highest peaks and 5 deepest valleys from entire measuring field > 0.88, peak count > 0.86). The parameter arithmetic mean of surface roughness showed a strong correlation with the subjective score (Pearson arithmetic mean of surface roughness 0.70; mean of 5 highest peaks and 5 deepest valleys from entire measuring field 0.53; peak count 0.54).

Limitations

The reliability and validity of the PRIMOS were only tested on skin and burn scars, not in other dermatologic diseases.

Conclusions

The PRIMOS is a valid and reliable tool for objective noninvasive evaluation of surface roughness of both skin and burn scars.

Section snippets

Patients

From January until June 2009, 60 patients with burn scars were recruited from the scar consulting hours in the outpatient clinic, which are held once a week in our burn center. Patients aged 12 years or older with a burn scar of 3 to 18 months postburn were measured. Patients with burn scars smaller than the measuring frame of the PRIMOS (30 × 40 mm) were excluded as were patients who lacked adequate communicative and cognitive abilities.

Procedure

In this study, all measurements and assessments were

Results

In this study, normal-appearing skin and scars of 60 patients were assessed by means of the PRIMOS and the POSAS. Table I shows the patient characteristics.

Discussion

In past years, research has focused on the validation of subjective and objective measuring systems for the assessment of scars. Research into the prevention and treatment of scars requires an easily applicable, objective measuring tool. In this study, a new measuring device for surface roughness was introduced, which was shown to be reliable and valid in assessing scarred and nonscarred skin. To our knowledge, no publication concerning the reliability and validity of the PRIMOS has been

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    Financed by Fonds Nuts Ohra, a nonprofit foundation supporting research with no professional interest in the design and outcome of this study.

    Conflicts of interest: None declared.

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