Secondary assessments
water loss
SCAR
Wound Closure: (a) SilhouetteStar measurement: The wounds were photographed with the SilhouetteStar™ camera (Aranz Medical Ltd.). The detailed images generated were used for wound closure assessment using the Silhouette Connect™ software. (b) Transepidermal water loss (TEWL): TEWL is a noninvasive measurement of the quantity of water that passes from inside a body and can be used to assess restoration of the skin barrier function. TEWL was measured from the wound and normal skin (baseline) using DermaLab TEWL Probe (cyberDERM, Inc., Broomall, PA) as published by us.Both observer and patient portions of the POSAS were completed at each assessment, with each variable measured as compared with normal skin. The same two independent observers completed the observer portion of the POSAS at each assessment to maintain consistency and to improve the reliability of the results. A score from 1 to 10 was assigned to each variable, with a score of 1 reflecting normal skin and 10 the worst scar imaginable. In addition, using the VSS the quality of healing was rated according to four parameters: vascularity (0–3), pigmentation (0–2), pliability (0–5), and height (0–3). Each parameter ranked subscales were summed to obtain a total score ranging from 0 (normal skin) to 13 (worst scar imaginable).