Key Outcomes for Evaluating Hand and Wrist Scars: A Nationwide Survey of Clinicians in Saudi Arabia

TL;DR

This study explores how healthcare professionals in Saudi Arabia assess hand and wrist scars, highlighting gaps in training and the need for standardized tools.

Contribution

The study identifies key scar outcome domains and training needs among clinicians in Saudi Arabia.

Findings

Most clinicians focus on physical symptoms and scar characteristics, with limited use of validated tools.

Psychological factors like self-confidence and scar acceptance are considered important but underutilized.

Only 37.8% of participants reported receiving specialized training in scar assessment.

Abstract

Background and Objectives: Hand and wrist scars alter physical appearance and can result in functional impairments and psychosocial difficulties. Although these effects are clinically important, rehabilitation services in Saudi Arabia lack consistent and standardised scar assessment protocols. The limited use of validated outcome measures hinders both clinical practice and research. Standardised scar assessment is essential for evidence synthesis, developing new scar care interventions and promoting best outcomes. We aim to investigate healthcare professionals’ perspectives on key scar outcome domains for evaluating hand and wrist scars and identify gaps in current practice and training needs to support the development of evidence-based guidelines. The study design is a cross-sectional descriptive study. Materials and Methods: The Saudi Commission for Health Specialties distributed a survey to 5000 randomly selected licensed healthcare professionals. The adapted questionnaire obtained sociodemographic data, professional experience, and ratings of scar outcome domains using a five-point Likert scale. Descriptive statistics were used for the analyses. Results: The analysis included 74 completed responses (response rate, 41.5%). Nurses (32.4%) and occupational therapists (29.7%) represented the largest groups. Only 37.8% of the participants reported receiving specialised training in scar assessment. Furthermore, the use of outcome measures remained limited, with 41.3% utilising clinician-reported outcome measures (CROMs) and 54.05% using patient-reported outcome measures (PROMs). The Vancouver Scar Scale and Patient and Observer Scar Assessment Scale were the most frequently used assessment tools. Clinicians primarily evaluated physical symptoms, including hypersensitivity (69.8%) and pain (67.6%), as well as scar characteristics such as colour (62.2%), adhesion (65.8%), and thickness (64.9%). Psychological factors were also considered important, particularly self-confidence (59.5%), acceptance of the scar (60.3%), and satisfaction with the scar (60.8%). Conclusions: Healthcare professionals in Saudi Arabia recognise the complex effects of hand and wrist scarring; however, they show limited integration of validated assessment tools, especially patient-reported outcome measures, in clinical practice. This gap suggests the need for targeted training, interdisciplinary educational initiatives, and efforts to strengthen standardised approaches to scar assessment. Exploring the development of future national guidance and engaging in international efforts to develop a core outcome measurement set may support evidence-based evaluation and improved long-term patient outcomes.

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