Patient satisfaction following scar revision: A systematic review and meta-analysis

Abstract

Background: Scar revision aims to improve the esthetic appearance and functional impact of scars. However, evidence synthesizing patient-reported satisfaction following these procedures remains limited.

Methods: We systematically searched PubMed/MEDLINE, EMBASE, and Google Scholar (2010-2024) for studies reporting patient satisfaction after scar revision in adults. The primary outcome was patient-reported satisfaction measured through validated patient-reported outcome measures (PROMs) or structured surveys. Secondary contextual outcomes included esthetic severity scores (patient and observer scar assessment scale (POSAS), observer scar assessment scale (OSAS), Vancouver scar scale (VSS)) and complication rates. Data were pooled using random-effects single-arm meta-analysis.

Results: Thirty studies involving 5230 patients met the inclusion criteria, including 8 RCTs, 5 systematic reviews (narrative only), and 17 observational studies. Surgical interventions demonstrated the most favorable POSAS scores (2.71, 95% CI 2.32-3.11), compared with non-surgical procedures (3.32, 95% CI 2.92-3.71). Across 25 studies (1432 patients), the pooled patient satisfaction rate was 78.6% (95% CI 74.3-82.8). Satisfaction was the highest among patients with traumatic scars (88.3%) and lower in those with burn scars (74.5%). Minor complications occurred in 8.6% of the patients, with higher rates in post-acne and post-surgical scars. No major complications were reported.

Conclusions: Scar revision is associated with high patient satisfaction, with surgical approaches generally producing superior patient-reported outcomes. Satisfaction varies according to scar etiology and follow-up duration, emphasizing the importance of expectation setting and ongoing assessment. Secondary outcomes support the overall safety and effectiveness of current techniques. Standardized PROMs and improved reporting of psychosocial and contextual factors are needed to strengthen future evidence and enhance patient-centered care.

Keywords: Patient satisfaction; Quality of life; Scar improvement; Scar revision; Scar treatment.