Background Hypertrophic scarring after burn injury is one of the greatest unmet challenges in patients with burn injuries. A better understanding of the characteristics of scar maturation and early prediction of the long-term outcome of scarring are prerequisites for improving targeted therapies and pivotal for patient counselling. Methods Repeated measurements of scar stiffness in 11 pediatric patients were performed over the course of 1 year using 2 suction devices, the Cutometer and the Nimble. In addition, the observer pliability score of the Patient and Observer Scar Assessment Scale was applied. This longitudinal study allowed quantification of the ability of each of the measured parameters to reflect scar maturation, as indicated by change in skin pliability/stiffness, over time (using linear regression); the ability to distinguish individual patients (intraclass correlation coefficient (ICC)); the correlation of the devices (Spearman correlation coefficient); and the ability to predict long-term scar maturation based on early scar assessment (using receiver operating characteristic). Results All the tools used showed significant longitudinal decrease of scar stiffness from 3 months until 12 months after the injury. The Nimble (ICCpatientNimble = 0.99) and the Cutometer (ICCpatientCuto = 0.97) demonstrated an excellent ability to distinguish between individual patients. The Nimble seemed to be able to predict the 12-month pliability of scars based on early (3-month) measurements (area under the curve (AUC)12mPOSAS = 0.67; AUC12mC = 0.46; AUC12mN = 0.79). Conclusions The results of this preliminary study suggest that all 3 tools provide suitable means to quantify alterations in scar stiffness over time. Initial evidence suggests the Nimble is most favorable for predicting changes in stiffness associated with long-term scar maturation. Further studies with a larger sample size are required to validate tissue suction as a clinical tool for analysis of changes of scar stiffness over time.

中文翻译：

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纵向监测和预测儿科患者瘢痕硬度的长期结果

背景 烧伤后的肥厚性瘢痕是烧伤患者最大的未解决挑战之一。更好地了解瘢痕成熟的特征和早期预测瘢痕形成的长期结果是改进靶向治疗的先决条件，也是患者咨询的关键。方法 在 1 年的时间里，使用 Cutometer 和 Nimble 这 2 种抽吸装置重复测量 11 名儿科患者的疤痕硬度。此外，应用了患者和观察者疤痕评估量表的观察者柔韧性评分。该纵向研究允许量化每个测量参数反映疤痕成熟的能力，如皮肤柔韧性/刚度随时间的变化所示（使用线性回归）；区分个体患者的能力（组内相关系数（ICC））；设备的相关性（Spearman 相关系数）；以及基于早期疤痕评估（使用接收器操作特征）预测长期疤痕成熟的能力。结果 使用的所有工具均显示伤后 3 个月至 12 个月的疤痕硬度纵向显着降低。Nimble (ICCpatientNimble = 0.99) 和 Cutometer (ICCpatientCuto = 0.97) 表现出出色的区分个体患者的能力。Nimble 似乎能够根据早期（3 个月）测量值（曲线下面积 (AUC)12mPOSA = 0.67；AUC12mC = 0.46；AUC12mN = 0.79）预测 12 个月的疤痕柔韧性。结论 这项初步研究的结果表明，所有 3 种工具都提供了合适的方法来量化疤痕硬度随时间的变化。初步证据表明，Nimble 最有利于预测与长期疤痕成熟相关的刚度变化。需要更大样本量的进一步研究来验证组织抽吸作为一种临床工具，用于分析疤痕硬度随时间的变化。