Ultrasound measurement of traumatic scar and skin thickness: a scoping review of evidence across the translational pipeline of research-to-practice.

OBJECTIVES: To identify the ultrasound methods used in the literature to measure traumatic scar thickness, and map gaps in the translation of these methods using evidence across the research-to-practice pipeline. DESIGN: Scoping review. DATA SOURCES: Electronic database searches of Ovid MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature and Web of Science. Grey literature searches were conducted in Google. Searches were conducted from inception (date last searched 27 May 2022). DATA EXTRACTION: Records using brightness mode (B-mode) ultrasound to measure scar and skin thickness across the research-to-practice pipeline of evidence were included. Data were extracted from included records pertaining to: methods used; reliability and measurement error; clinical, health service, implementation and feasibility outcomes; factors influencing measurement methods; strengths and limitations; and use of measurement guidelines and/or frameworks. RESULTS: Of the 9309 records identified, 118 were analysed (n=82 articles, n=36 abstracts) encompassing 5213 participants. Reporting of methods used was poor. B-mode, including high-frequency (ie, >20 MHz) ultrasound was the most common type of ultrasound used (n=72 records; 61% of records), and measurement of the combined epidermal and dermal thickness (n=28; 24%) was more commonly measured than the epidermis or dermis alone (n=7, 6%). Reliability of ultrasound measurement was poorly reported (n=14; 12%). The scar characteristics most commonly reported to be measured were epidermal oedema, dermal fibrosis and hair follicle density. Most records analysed (n=115; 97%) pertained to the early stages of the research-to-practice pipeline, as part of research initiatives. CONCLUSIONS: The lack of evaluation of measurement initiatives in routine clinical practice was identified as an evidence gap. Diverse methods used in the literature identified the need for greater standardisation of ultrasound thickness measurements. Findings have been used to develop nine methodological considerations for practitioners to guide methods and reporting.

Ultrasound measurements of pathological and physiological skin thickness: a scoping review protocol.

INTRODUCTION: Ultrasound is a quick, safe, and non-invasive imaging method that can be used to measure skin thickness in pathological cutaneous conditions in clinical and research settings. Despite widespread use, there exists a lack of standardisation and reporting of ultrasound skin thickness measurement methods, which makes between-studies comparisons difficult. To address this, we present a scoping review protocol, which aims to determine what is and is not known about the measurement of skin and scar thickness using ultrasound in people with traumatic scars. METHODS AND ANALYSIS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and Joanna Briggs Institute scoping review methodology will be used to guide this review. Electronic database searching will be conducted in Ovid MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature and Web of Science. No date limit will be imposed on the database searches. Records will be supplemented with searches of reference lists of included studies and grey literature in OpenGrey and Google Advanced. Screening will be conducted by two independent reviewers, and studies where ultrasound is used to measure skin and scar thickness in people with traumatic scars will be included. Data extraction will include ultrasound methods (eg, transducer orientation), psychometric properties (eg, reliability, measurement error), health service and implementation outcomes (eg, feasibility, acceptability) and factors influencing ultrasound measurement of skin thickness (eg, body location, age). ETHICS AND DISSEMINATION: Ethical approval is not required for this investigation, as published literature will form the basis of the review. The review will be published in a peer-reviewed scientific journal and is expected to result in the development of the first evidence-based and consensus-based methodological guideline for skin thickness measurement by ultrasound.

B-mode Ultrasound Measurement of Facial Soft Tissue Thickness for Craniofacial Identification: A Standardized Approach.

Facial soft tissue thicknesses (FSTT) have long formed a quantitative cornerstone of craniofacial identification methods. Measurement approaches could, however, be improved by standardization that enhances the utility/comparability of these FSTT data between studies and authors. This applies equally within the broad classes of measurement techniques, just as it does between them, where many different varieties of tools, tool settings, and practitioner techniques are used within each measurement modality. Although B-mode ultrasound is popularly used and holds some prime advantages, such as the measurement of upright living subjects, technical recommendations that provide basic underlying data structure and standardization are essentially nonexistent. This paper provides the first systematic and illustrated description of a standardized B-mode ultrasound measurement method designed to maximize data utility for craniofacial identification purposes.