Introduction and Aim:

The Vancouver scar is widely used for scar assessment but lacks objectivity. Objective assessment of scar pliability to evaluate the progress of scar maturation and response to treatment is of great clinical value. We present a novel minimally invasive 3D imaging technique to objectively measure scar pliability.

Materials and Method:

Compression stress with Semms-Weinstein monofilaments of varying tensile give force (20-60 grams) was initially applied to normal deltoid skin to assess reliability in volunteers. Subsequently compression stress was applied to the hypertrophic / keloid scar and compared with the mirror image normal side. Images of the negative volume created by the indenting filament on the scar and normal skin were taken by high-resolution 3D surface imaging.

Results:

There was a strong positive correlation between compression force applied and negative volume created by the Semms-Weinstein monofilament (Pearson's rank correlation coefficient, r= 0.99). There was a significant difference between negative volume changes between the control and scar sites (p<0.05, Mann-Whitney test). Minimum measurable volume change was 0.02575 CC +/- 0.00296.

Conclusion:

This is a first study to demonstrate the clinical applicability of 3D imaging in objective assessment of skin and scar pliability. In conjunction with volume and colour analysis this 3D system is a powerful tool for objective scar assessment.

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