前言:穿戴壓力衣療法是最常用來預防燒燙傷後不正常疤痕增生的方法之一，本研究主要在比較以「色度計」與「溫哥華疤痕量表」觀察燒燙傷患者穿戴壓力衣治療後的疤痕變化之差異性與相關性;其次在比較以「色度計」與「溫哥華疤痕量表」來評量穿戴壓力衣治療後疤痕變化的「照片」與以「色度計」與「溫哥華疤痕量表」「直接」觀測疤痕變化的差異性與相關性。方法:本研究共收錄11 位個案，其中男性5 位，女性6 位，平均年齡為43.9 ± 14.5 歲，合計47 處燒燙傷疤痕部位。所有個案受測疤痕部位均穿戴壓力衣治療達24 週並於穿戴第1 天、第12 週與第24 週接受評估。每次量測的內容有:( 一)「色度計」的總色差值△T 來評估燒燙傷疤痕經過壓力衣治療後與周圍正常皮膚顏色間的顏色差異。( 二)「溫哥華疤痕量表」的總分值來評估燒燙傷疤痕經過壓力衣治療後整體疤痕狀況變化。( 三) 拍攝受測疤痕部位的數位照片並沖洗為「照片」後，再以「色度計」取得總色差值△T 與「溫哥華疤痕量表」的總分值，上述資料會再與「直接測量」取得的「色度計」的總色差值△T 與「直接觀察」取得的「溫哥華疤痕量表」的總分值進行資料分析。結果:所有受測疤痕部位共進行三次「直接」觀測與三次間接透過「照片」觀測，結果顯示: ( 一) 以「色度計」「直接」測量獲得總色差值△T 之平均值分別為13.7 (± 5.5)、14.8 (± 6.6) 與12.1 (± 6.0);透過「照片」測量獲得總色差值△T 之平均值分別為14.7 (± 6.0)、13.2 (± 5.7) 與12.3 (± 5.1)。整體疤痕總色差值△T 逐漸變小代表愈接近正常膚色，顯示壓力衣治療後有復原傾向，在使用「色度計」上比較「直接」測量與透過「照片」測量所得到的總色差值△T，p > .05，顯示兩者間並無顯著差異。( 二) 以「溫哥華疤痕量表」「直接」評估所得之總分分別為5.2 (± 1.5)、5.0 (± 2.1) 與4.0 (± 2.5);透過「照片」評估所得之總分分別為6.0 (± 1.5)、5.3 (± 2.6) 與4.4(± 3.2)。整體疤痕總分逐漸變小代表疤痕狀況愈接近正常皮膚狀況，顯示壓力衣治療後有復原傾向，使用「溫哥華疤痕量表」比較「直接」評估與透過「照片」評估得到的總分值，p > .05，顯示兩者間無顯著差異。( 三) 以組內相關係數(Intraclass Correlation Coefficient, ICC) 分析比較(a)、「色度計」測量燒燙傷疤痕在各時期「直接」測量和「照片」測量間的相關係數分別為.422 (95% CI, .159 to .630)、.310 (95% CI, .035 to .543) 與.485 (95% CI, .230 to .677)，p < .05，顯示「直接」測量和「照片」測量間有中度相關的一致性。(b)、以「溫哥華疤痕量表」評估燒燙傷疤痕在各時期「直接」評估和「照片」評估間的組內相關係數分別為.544 (95% CI, .243 to .736)、.634 (95% CI, .427 to .778) 與.762 (95% CI, .610 to .860)，p < .001，顯示「直接」評估和「照片」評估間有中至高度相關的一致性。結論:「色度計」或「溫哥華疤痕量表」測量評估燒燙傷疤痕，比較「直接」和透過「照片」測量評估兩者所得的結果無統計上顯著差異，顯示透過「照片」所測量評估的結果或可取代臨床「直接」測量評估的結果。另外，發現「溫哥華疤痕量表」在臨床「直接」評估與間接透過「照片」評估間有中至高度相關。顯示透過「照片」以「溫哥華疤痕量表」來判斷評估疤痕狀況確實可以作為燒燙傷疤痕治療成果評量工具之選擇。

Introduction: Pressure garment therapy (PGT) is one of the most common ways to prevent hypertrophic scar after burns. First, this study compared the differences and investigated the correlations of scar changes between using the colorimeter and Vancouver scar scale (VSS) in burn patients after PGT. Secondly, it compared the differences and correlations between “indirect photo” and “direct observation” after PGT through the “colorimeter” and “VSS”. Method: In our study, we recruited 11 participants (5 males, 6 females) with total of 47 scar-sites scars and the mean age was 43.9 ± 14.5 years. All subjects were treated through PGT more than 24 weeks and evaluated on Day 1, Week 12 and Week 24. Each measurement included: (1) Total color difference (△T) of the “colorimeter” was used to evaluate the color difference between burned scar and normal skin after PGT. (2) The total score of the “VSS” was used to assess the change in overall scar condition treated through PGT. (3) After taking a digital photo of the scar area and flush photo, then using the “colorimeter” to obtain the total color difference (△T) and the total score of “VSS”. Finally, we combined the total color difference (△T) of the “colorimeter” obtained from “direct measure” and the total score of the “VSS” obtained from the “direct observation” for data analyzed. Results: All the measured scars were evaluated by three “direct” and three “indirect photo” assessments. The results showed that: (1) through three “direct” measurements, the average total color difference (△T) of “colorimeter” were 13.7 (± 5.5), 14.8 (± 6.6) and 12.1 (± 6.0); and three “indirect photo” measurements, the average total color difference (△T) of “colorimeter” were 14.7 (± 6.0), 13.2 (± 5.7) and 12.3 (± 5.1). The overall total color difference (△T) of the overall scar gradually became smaller, it meant that scar color was closer to the normal color and indicated the recovered tendency after PGT. Total color difference (△T) between “direct” measurements and” indirect photo” on “colorimeter” showed no significant difference, p < .05. (2) Through three “direct” observations, the total scores of the “VSS” were 5.2 (± 1.5), 5.0 (± 2.1) and 4.0 (± 2.5); and three “indirect photo” observations, the total scores were 6.0 (± 1.5), 5.3 (± 2.6) and 4.4 (± 3.2). The overall total scores of “VSS” gradually became smaller; it meant that scar condition was closer to the normal skin condition and indicated the recovered tendency after PGT. Using total scores of “VSS” to compare “direct” observations and “indirect photo” on scar condition showed no significant difference, p < .05. (3) Analysis and comparison by Intraclass Correlation Coefficient (ICC) (a) The ICC between using colorimeter “direct” measurements and “indirect photo” of burn scars in each period was .422 (95% CI, .159 to .630), .310 (95% CI, .035 to .543) and .485 (95% CI, .230 to .677), and it showed a moderate relevance consistency between the “direct” and “indirect photo” measurement, p < .05. (b) The ICC between using VSS “direct” measurements and “indirect photo” of burn scars in each period were 0.544 (95% CI, .243 to .736), .634 (95% CI, .427 to .778) and .762 (95% CI, .610 to .860), it showed a moderate to high relevance consistency between the “direct” and the “indirect photo” assessment, p < .001. Conclusion: Our study showed that there was no statistically significant difference between the results of the “direct” and “indirect photo” measurements through the “colorimeter” and “VSS” assessment on burn scars after PGT. It meant that the clinical “direct” assessment may replace by “indirect photo”. In addition, through the “VSS” evaluation, it had a moderate to high correlation between clinical “direct” and “indirect photo” assessment. Therefore, using “indirect photo” to estimate the scar condition through “VSS” can indeed be used as a tool for assessing the treatment of burn scars.