溫哥華疤痕評量尺（Vancouver scar scale,VSS)－傷口大師

游朝慶

溫哥華疤痕評量尺（Vancouver scar scale,VSS)是由加拿大溫哥華總醫院燒傷中心的Sullivan於1990年發表出來¹，或許是世界上最廣為熟知的燒傷疤痕評估系統，又被公認為Burn Scar Index。其採用色澤（Pigmentation)、厚度（height)、血管分佈（vascularity)、柔軟度（pliability）四個指標對疤痕進行描述性評價，評分標準如下：

Pliability柔軟度	0	Normal
	1	Supple柔軟的（在最少阻力下皮膚能變形的）Supple, flexible with minimal resistance)
	2	Yielding有彈性的，柔順的（在壓力下能變形的）(giving way to pressure, offering moderate resistance but does not behave as a solid mass of scar)
	3	Firm結實的，硬的（不能變形的，移動呈塊狀，對壓力有阻力(solid, inflexible unit, not easily moved, resistant to manual pressure)
	4	Banding彎曲（組織如繩狀，瘢痕伸展時會退縮）(rope-like tissue that blanches with extension of scar, does not limit ROM)
	5	Contracture攣縮（瘢痕永久性短縮導致殘廢與扭曲）(permanent shortening of the scar producing deformity or distortion, limits ROM)
Height厚度	0	Normal
	1	<2 mm
	2	2-5 mm
	3	>5 mm
Vascularity血管分布	0	Normal瘢痕膚色和身體正常部位近似
(redness)	1	Pink膚色偏粉紅(slight increase in local blood supply)
	2	Red膚色偏紅(significant increase in local blood supply)
	3	Purple膚色呈紫色(excessive increase in local blood supply)
Pigmentation色澤	0	Normal color (close to normal skin)
	1	Hypopigmentation色澤較淺
	2	Hyperpigmentation色澤較深⁭
Total score	13

除了燒傷疤痕外，也有人證實VSS對手術傷口的線性疤痕的評估也有效^2,3。

References

1. Sullivan T, Smith J, Kermode J et al. Rating the burn scar. J Burn Care Rehabil 1990; 11:256-260.

2. Truong PT, Abnousi F, Yong CM et al. Standardized assessment of breast cancer surgical scars integrating the Vancouver Scar Scale, Short-Form McGill Pain Questionnaire, and patients' perspectives. Plast Reconstr Surg 2005; 116:1291-1299.

3. Truong PT, Lee JC, Soer B et al. Reliability and validity testing of the Patient and Observer Scar Assessment Scale in evaluating linear scars after breast cancer surgery. Plast Reconstr Surg 2007; 119:487-494.