Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study

Abstract Though widely used to assess pathological scars, the modified Vancouver Scar Scale (mVSS) is neither convenient nor objective. Shear wave elastography (SWE) is used to evaluate the stiffness of pathological scars. We aimed to determine the correlation between mVSS score and elastic modulus...

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Autores principales:	Jing Hang, Jie Chen, Weixin Zhang, Tao Yuan, Yang Xu, Bingrong Zhou
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/29eaca82c0ac44fab8094f08b9806bf8
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spelling	oai:doaj.org-article:29eaca82c0ac44fab8094f08b9806bf82021-12-05T12:16:21ZCorrelation between elastic modulus and clinical severity of pathological scars: a cross-sectional study10.1038/s41598-021-02730-02045-2322https://doaj.org/article/29eaca82c0ac44fab8094f08b9806bf82021-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02730-0https://doaj.org/toc/2045-2322Abstract Though widely used to assess pathological scars, the modified Vancouver Scar Scale (mVSS) is neither convenient nor objective. Shear wave elastography (SWE) is used to evaluate the stiffness of pathological scars. We aimed to determine the correlation between mVSS score and elastic modulus (EM) measured by SWE for pathological scars. Clinical information including ultrasound (US) results of the enrolled patients with pathological scars was analyzed. The clinical severity of the pathological scars was evaluated by mVSS. Skin stiffness, as represented by EM, was calculated using SWE. The average EM of the whole scar (EMWHOLE), hardest part of the scar (EMHARDEST), and normal appearance of the skin around the scar (EMNORMAL) were also recorded. Enrolled in this study were 69 pathological scars, including 28 hypertrophic scars and 41 keloids. The univariable regression analyses showed that the EM of pathological scars was closely related to mVSS score, while the linear multivariable regression analyses showed no significantly correlation. Curve fitting and threshold effect analysis revealed that when EMWHOLE was less than 166.6 kPa or EMHARDEST was less than 133.07 kPa, EM was positively correlated with mVSS score. In stratified analysis, there was no significant linear correlation and threshold effect between EMWHOLE and mVSS score in hypertrophic scars or keloids. However, the fully adjusted smooth curves presented a linear association between mVSS score and EMHARDEST in keloids (the adjusted β [95% CI] was 0.010 [0.001, 0.018]), but a threshold and nonlinear association were found in hypertrophic scars. When EMHARDEST was less than 156.13 kPa, the mVSS score increased along with the hardest scar part stiffness; the adjusted β (95% CI) was 0.024 (0.009, 0.038). In conclusion, EM of pathological scars measured by SWE were correlated with mVSS within a threshold range, and showed different association patterns in hypertrophic scars and keloids.Jing HangJie ChenWeixin ZhangTao YuanYang XuBingrong ZhouNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jing Hang Jie Chen Weixin Zhang Tao Yuan Yang Xu Bingrong Zhou Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
description	Abstract Though widely used to assess pathological scars, the modified Vancouver Scar Scale (mVSS) is neither convenient nor objective. Shear wave elastography (SWE) is used to evaluate the stiffness of pathological scars. We aimed to determine the correlation between mVSS score and elastic modulus (EM) measured by SWE for pathological scars. Clinical information including ultrasound (US) results of the enrolled patients with pathological scars was analyzed. The clinical severity of the pathological scars was evaluated by mVSS. Skin stiffness, as represented by EM, was calculated using SWE. The average EM of the whole scar (EMWHOLE), hardest part of the scar (EMHARDEST), and normal appearance of the skin around the scar (EMNORMAL) were also recorded. Enrolled in this study were 69 pathological scars, including 28 hypertrophic scars and 41 keloids. The univariable regression analyses showed that the EM of pathological scars was closely related to mVSS score, while the linear multivariable regression analyses showed no significantly correlation. Curve fitting and threshold effect analysis revealed that when EMWHOLE was less than 166.6 kPa or EMHARDEST was less than 133.07 kPa, EM was positively correlated with mVSS score. In stratified analysis, there was no significant linear correlation and threshold effect between EMWHOLE and mVSS score in hypertrophic scars or keloids. However, the fully adjusted smooth curves presented a linear association between mVSS score and EMHARDEST in keloids (the adjusted β [95% CI] was 0.010 [0.001, 0.018]), but a threshold and nonlinear association were found in hypertrophic scars. When EMHARDEST was less than 156.13 kPa, the mVSS score increased along with the hardest scar part stiffness; the adjusted β (95% CI) was 0.024 (0.009, 0.038). In conclusion, EM of pathological scars measured by SWE were correlated with mVSS within a threshold range, and showed different association patterns in hypertrophic scars and keloids.
format	article
author	Jing Hang Jie Chen Weixin Zhang Tao Yuan Yang Xu Bingrong Zhou
author_facet	Jing Hang Jie Chen Weixin Zhang Tao Yuan Yang Xu Bingrong Zhou
author_sort	Jing Hang
title	Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
title_short	Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
title_full	Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
title_fullStr	Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
title_full_unstemmed	Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
title_sort	correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/29eaca82c0ac44fab8094f08b9806bf8
work_keys_str_mv	AT jinghang correlationbetweenelasticmodulusandclinicalseverityofpathologicalscarsacrosssectionalstudy AT jiechen correlationbetweenelasticmodulusandclinicalseverityofpathologicalscarsacrosssectionalstudy AT weixinzhang correlationbetweenelasticmodulusandclinicalseverityofpathologicalscarsacrosssectionalstudy AT taoyuan correlationbetweenelasticmodulusandclinicalseverityofpathologicalscarsacrosssectionalstudy AT yangxu correlationbetweenelasticmodulusandclinicalseverityofpathologicalscarsacrosssectionalstudy AT bingrongzhou correlationbetweenelasticmodulusandclinicalseverityofpathologicalscarsacrosssectionalstudy
_version_	1718372066086879232

Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study

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