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Project

Unraveling factors predicting post-surgical hypertrophic scar formation: A prospective study based on a digital biopsychosial care pathway

Surgery can have an enormous impact on a person's life. Besides the emotional reasons (receiving a diagnosis, having to undergo (urgent) surgery, etc.), the aftermath can be heavy for the patient. Rehabilitation periods can be long, and after that period, the patient remains with a scar, which can be debilitating. The incidence of hypertrophic scarring of postsurgical incision ranges from 40% to 70%. Although at the time of development, this hypertrophic scarring is not considered a top priority, as the patient is still in the rehabilitation phase, it has been shown that hypertrophic scars greatly impact the person's quality of life. As such, it is important to prevent this process of hypertrophic scarring. However, until now there is limited specific follow-up to examine post-surgical scar conditions, so it is not clear what factors contribute to the development of hypertrophic scars and whether they are preventable. Therefore, the aim of the current application is to identify factors, inventoried by patient reported outcome measures and objective scar assessment, predicting post-surgical pathologic scar formation. Recently we have developed an e-health application for fast detection of abnormal scar formation, enabling the proposed study by offering fast and real time data recording and analysis of both patient and scar related information. The unique and specific scientific importance lies within the fact that with this study we may reveal critical points in which abnormal scar formation occurs post-surgery. Moreover, we may reveal predictors that make the difference between normotrophic and pathologic hypertrophic scar formation. If adjustable risk factors are identified we can prevent hypertrophic post-surgical by early and continuous screening, greatly enhancing patient's QOL after surgery. To achieve these goals a prospective study will be set up with specific data collection the first months after surgical incision. Evaluating self-reported scar quality, symptoms and quality of life included in the e-health tool Scarpath together with the objective examination of the scar (e.g. scar redness, elasticity) allows us to closely monitor the progression over time and allows us to gather large amount of scar and patient related parameters during wound healing which may lead to normal or hypertrophic scars. This is the first study that attempts to unravel factors leading to post-surgical hypertrophic scar formation with a patient-centered e-health based data registration system. As such, it is the first study that makes use of several PROMs which (in their paper version) are being used worldwide in the scar-related context, and can provide a proof of concept for further e-health applications. With establishing risk factors from this study future research may reveal whether specific interventions or prevention strategies are useful and as such greatly impacting patient's QOL post-surgery.
Date:1 Jul 2020 →  31 Dec 2021
Keywords:UPDATE PROCEDURES, PREVENTION, SCAR, DIGITALIZATION
Disciplines:General diagnostics, Kinesitherapy, Physiotherapy, Rehabilitation