Comparison of Clinical Estimation and Stereophotogrammic Instrumented Imaging of Burn Scar Height and Volume

Abstract

Descriptive clinical tools for characterizing burn scars are limited by between-user variability and unknown sensitivity to change over time. We previously described preclinical assessment of stereophotogrammetry as a valid measure of burn-related scars. Here, we compared the estimated vs. instrumented measurements of maximum height and total positive volume of 26 burn scars. The burn scars were imaged with the QuantifiCare LifeViz Micro 3D camera. Three experienced wound care therapists first estimated, then measured using 3D Track software, the imaged scars’ height and volume. Two-factor analysis without replication was performed to calculate intraclass correlation coefficients (ICCs) between assessors’ estimated scar height and volume, and measured height and volume. Two-sided Wilcoxon tests were performed comparing the mean estimated height and volume with the estimated and measured outputs. The estimated scar height’s ICC was 0.595, and for volume, it was 0.531. The measured scar height’s ICC was 0.933 and for volume, it was 0.890. The estimated and measured volume were significantly different (z = −2.87, p = 0.041), while the estimated and measured height were not (z = −1.39, p = 0.161). Stereophotogrammic measurement of scar height and volume is more reliable than clinical photograph assessment. Stereophotogrammetry should be utilized when assessing burn scar height and volume, rather than subjective estimates from clinical scar tools.