- Pneumatonometer uses pressure to objectively measure skin pliability. It is composed of a sensor, a membrane, and an air-flow system that measures the amount of pressure needed to lock the system. Most commonly used to measure intra-ocular pressure.
- Cutometer is a noninvasive suction device that has been applied to the objective and quantitative measurement of skin elasticity. It measures the viscoelasticity of the skin by analyzing its vertical deformation in response to negative pressure. (photo credit)
- Durometer measures tissue firmness by applying a vertically directed indentation load on the scar. It was originally described for use in scleroderma.
- Chromameter (Minolta, Tokyo, Japan)
- DermaSpectrometer (cyberDERM, Inc, Media, PA, USA)
- Mexameter (Courage-Khazaka, Cologne, Germany)
- Tristimulus colorimeter
- Ultrasound scanners, such as the tissue ultrasound palpation system (TUPS) -- “TUPS was found to demonstrate a moderate correlation in terms of reliability. TUPS does have drawbacks, however, in that it requires technical training and experience in image interpretation and is relatively expensive compared to other modalities.”
- 3-dimensional optical profiling system (Primos imaging) made by GFMesstechnik (Germany)
- The Vancouver Scar Scale (VSS) -- first described by Sullivan in 1990. It assesses 4 variables: vascularity, height/thickness, pliability, and pigmentation. Patient perception of his or her respective scars is not factored in to the overall score.
- Manchester Scar Scale (MSS) -- proposed in 1998. It assesses and rates 7 scar parameters: scar color (perfect, slight, obvious, or gross mismatch to surrounding skin), skin texture (matte or shiny), relationship to surrounding skin (range from flush to keloid), texture (range normal to hard), margins (distinct or indistinct), size (<1 cm, 1–5 cm, >5 cm), and single or multiple.
- Patient and Observer Scar Assessment Scale (POSAS) -- includes subjective symptoms of pain and pruritus and expands on the objective data captured in the VSS. It consists of 2 numerical numeric scales: The Patient Scar Assessment Scale and the Observer Scar Assessment Scale. It assesses vascularity, pigmentation, thickness, relief, pliability, and surface area, and it incorporates patient assessments of pain, itching, color, stiffness, thickness, and relief. The POSAS is the only scale that considers subjective symptoms of pain and pruritus, but like other scales it also lacks functional measurements as to whether the pain or pruritus interferes with quality of life.
- Visual Analog Scale (VAS) -- is a photograph-based scale derived from evaluating standardized digital photographs in 4 dimensions (pigmentation, vascularity, acceptability, and observer comfort) plus contour. It sums the individual scores to get a single overall score ranging from "excellent" to "poor." It has demonstrated high observer reliability and internal consistency when compared to expert panel evaluation, but it has shown only moderate reliability when used among lay panels.
- Stony Brook Scar Evaluation Scale (SBSES) -- was proposed in 2007. It is a 6-item ordinal wound evaluation scale developed to measure short-term cosmetic outcome of wounds 5 to 10 days after injury up to the time of suture removal. It incorporates assessments of individual attributes with a binary response (1 or 0) for each, as well as overall appearance, to yield a score ranging from 0 (worst) to 5 (best). It was designed to measure short-term rather than long-term wound outcomes.