COMPARISON OF PATIENT SATISFACTION AND PRACTITIONER SATISFACTION WITHWOUND APPEARANCE AFTER TRAUMATIC WOUND REPAIR

Introduction: Existing cosmetic scales for wounds are based only on pr actitioners' evaluations. They have not been validated using the patie nt's assessment.Objective: To validate a previously developed wound co smesis scale by determining the relationship between patient and pract itioner assessments of cosmetic outcome following traumatic wound repa ir. Methods: A convenience sample of patients with lacerations repaire d in an ED were evaluated at the time of suture removal. Practitioners assigned 0 or 1 point each for the presence or absence of a step-off of borders; contour irregularities; margin separation; edge inversion; excessive distortion; and overall appearance. A total cosmetic score was calculated by adding the categories above, As previously defined, a score of 6 was considered optimal; <6 was considered ''suboptimal.'' Patients, blinded to the physician score, assessed their degrees of s atisfaction with the cosmetic outcome of the wounds using a 100-mm vis ual analog scale (VAS). Because VAS scores were not normally distribut ed, practitioner scores were compared with patient satisfaction scores using a Mann-Whitney U test. Results: 125 patients were enrolled, of whom 64% were male; the median age was 19.5 years (interquartile range =8-33 years). Wounds were located predominantly on the face, scalp, or neck (47%) and upper extremity (35%), and had a median length of 2 cm . The 86 lacerations given optimal practitioner scores had a median pa tient satisfaction score of 97 mm; the 39 ''suboptimal'' lacerations h ad a median patient satisfaction score of 87 mm (p=0.0006). Conclusion : Lacerations that practitioners considered to have optimal cosmetic a ppearances at the time of suture removal received higher patient satis faction scores than did lacerations considered to be suboptimal. This provides a measure of validity to this 6-item categorical cosmetic sca le.