First published on March 11, 2010

Physical Therapy 2010;90:776.

Physical Therapy
DOI: 10.2522/ptj.20090048
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Research Reports

Validation of a New Device to Measure Postsurgical Scar Adherence

Giorgio Ferriero, Stefano Vercelli, Ludovit Salgovic, Valeria Stissi and Francesco Sartorio

G. Ferriero, MD, is Physiatrist, Fondazione Salvatore Maugeri, Istituto Scientifico di Veruno, Servizio di Fisiatria Occupazionale ed Ergonomia, Via per Revislate 13, I-28010, Veruno (NO), Italy.
S. Vercelli, PT, is Physical Therapist, Unit of Occupational Rehabilitation and Ergonomics, Instituto Scientifico di Veruno, Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione.
L. Salgovic, MD, CSc, is Lecturer in Surgery, Univerzita sv Cyrila a Metoda, Trnava, Slovak Republic.
V. Stissi, PT, is Physical Therapist, Unit of Occupational Rehabilitation and Ergonomics, Instituto Scientifico di Veruno, Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione.
F. Sartorio, PT, is Physical Therapist, Unit of Occupational Rehabilitation and Ergonomics, Instituto Scientifico di Veruno, Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione.

giorgio.ferriero{at}fsm.it

Background and Purpose: Scarring after surgery can lead to a wide range of disorders. At present, the degree of scar adhesion is assessed manually and by ordinal scales. This article describes a new device (the Adheremeter) to measure scar adhesion and assesses its validity, reliability, and sensitivity to change.

Design: This was a reliability and validity study.

Setting: The study was conducted at the Scientific Institute of Veruno.

Participants and Methods: Two independent raters, a physical therapist and a physical therapist student, used the Adheremeter to measure scar mobility and contralateral normal skin in a sample of 25 patients with adherent postsurgical scars before (T1) and after (T2) physical therapy. Two indexes of scar mobility, the adherence's surface mobility index (SMA) and the adherence severity index (AS), were calculated. Their correlation with the Vancouver Scar Scale (VSS) and its pliability subscale (PL-VSS) was assessed for the validity analysis.

Results: Both the SMA and the AS showed good-to-excellent intrarater reliability (intraclass correlation coefficient [ICC]=.96) and interrater reliability (SMA: ICC=.97 and .99; AS: ICC=.87 and .87, respectively, at T1 and T2), correlated moderately with the VSS and PL-VSS only at T1 (rs=–.58 to –.66), and were able to detect changes (physical therapist/physical therapist student): z score=–4.09/–3.88 for the SMA and –4.32/–4.24 for the AS; effect size=0.6/0.4 for the SMA and 1.4/1.2 for the AS; standard error of measurement=4.59/4.79 mm2 for the SMA and 0.05/0.06 for the AS; and minimum detectable change=12.68/13.23 mm2 for the SMA and 0.14/0.17 for the AS.

Limitations: The measurement is based on the rater's evaluation of force to stretch the skin and on the patient's judgment of comfort.

Discussion and Conclusions: The Adheremeter showed a good level of reliability, validity, and sensitivity to change. Further studies are needed to confirm these results in larger cohorts and to assess the device's validity for other types of scars.


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