Patients and Doctors Don't See Post-Surgical Scars The Same Way

By Jane Farrell

When it comes to post-surgical scarring, patients and doctors sometimes don’t see eye to eye.

Researchers from the Perelman School of Medicine at the University of Pennsylvania found patients and physicians disagreed in their scar evaluations 28 percent of the time. Patients were likelier to focus on the depth of the scar, according to a news release from the medical school. On the other hand, physicians were likelier to emphasize color and texture.

The study’s authors say these findings, published in JAMA Facial and Plastic Surgery, point to the need for better evaluation methods and improved preoperative counseling.

About 230 million surgical procedures are performed worldwide each year overall. That includes surgeries that are gender-specific like cesarean sections or breast reconstruction, as well as procedures that are the same for all patients such as skin cancer surgery. In addition to the type of procedure, there are multiple other factors that impact the scars various procedures leave on a person’s body, such as method of skin incision, method of wound closure, suturing technique, or postoperative wound care.

“Our analysis includes results across multiple specialties and using multiple methods, which shows this patient-surgeon discrepancy is not limited to any particular discipline or intervention,” said the study’s senior author Joseph F. Sobanko, MD, an assistant professor of Dermatology and director of Dermatologic Surgery Education at Penn.

Sobanko and his team looked at studies from 1972 through 2015. They ended up with 29 studies involving 4,485 patients.

“It is somewhat common for patients to have post-surgical scars that are considered clinically acceptable but patients may still feel disfigured,” Sobanko said. “Many of the scales currently used to evaluate scars are insufficient to measure subtle scar features and patient satisfaction.These findings may help to improve preoperative counseling and highlight the importance of developing scar measures that balance the perceptions of patients and physicians.”

He said further research is needed to understand patient and physician expectations during initial visits, as well as how the anatomic location of the scar affects perception.