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Dermatography improves patient QOL after head, neck surgeries

Dermatography as an adjuvant procedure after head and neck surgery improved patients’ perception of the appearance of scars or skin grafts as well as quality of life, according to data recently published in JAMA Facial Plastic Surgery.

Fifty-six patients (75% women; mean age, 56.5 years) who underwent dermatography in Amsterdam participated in a questionnaire to assess their opinions before and after their the procedure. Brigitte H. Drost, MD, in the department of head and neck oncology and surgery at Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, and colleagues modified two previously validated questionnaires for their study.

The Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty, a rating system based on a visual analog scale (VAS) ranging from 0 (“very ugly”) to 10 (“very nice”) was altered for wording and given to the patients before and after dermatography. The researchers then took nine questions from the Patient Scar Assessment Questionnaire to further clarify the patients’ opinions on appearance, scar consciousness and satisfaction on a five-point scale.

Questionnaire results indicated a mean difference on the VAS scale of –4 (95% CI, –4.6 to –3.3) before the procedure. After dermatography, the mean score improved to 7.8. Results from the second questionnaire showed uniform improvement of approximately 1 point across the nine questions (range, P = 5.6 × 10^–6 to P = 1.5 × 10^–9).

The researchers noted one exception to the results of improvement in a patient with a history of inflammation and radiotherapy before dermatography, resulting in a more difficult treatment and worse VAS score after treatment. However, the remaining patients reported improvement to lesion appearance and quality of life regarding the scar or skin graft.

“Dermatography has numerous advantages, including no donor-site morbidity, availability of a wide range of colors, no requirement for hospitalization or general anesthesia, permanent camouflage, and well-preserved sensation,” Drost and colleagues wrote. “Moreover, coloring of scars can be combined with intracicatricial keloidectomy, in which the volume of hypertrophic scars is reduced by the cutting action of the needles. This action smoothens the scar and reduces scar tension.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.