99 lines
2.9 KiB
Mathematica
99 lines
2.9 KiB
Mathematica
DVBCWSW3 ;ALB/CMM SCARS WKS TEXT - 1 ; 11/20/02 3:04pm
|
|
;;2.7;AMIE;**49**;Apr 10, 1995
|
|
;
|
|
;
|
|
TXT ;
|
|
;;A. Review of Medical Records:
|
|
;;
|
|
;;
|
|
;;
|
|
;;B. Medical History (Subjective Complaints):
|
|
;;
|
|
;; 1. Type of injury or infection causing the wound or scar, its
|
|
;; date, the treatment used, and the response to such treatment.
|
|
;;
|
|
;;
|
|
;; 2. Current symptoms.
|
|
;;
|
|
;;
|
|
;;C. Physical Examination (Objective Findings):
|
|
;;
|
|
;; For every scar to be examined, address EACH of the following and
|
|
;; fully describe the current findings. Note that, in addition
|
|
;; to measuring the scar itself, measurements of areas with certain
|
|
;; abnormal characteristics must also be provided. All measurements
|
|
;; should be reported in inches or centimeters.
|
|
;; 1. Describe precise location of each scar. Draw diagram if
|
|
;; necessary.
|
|
;;
|
|
;;
|
|
;; 2. Give MEASUREMENT of length and width (at its widest part) of
|
|
;; each scar.
|
|
;;
|
|
;;
|
|
;; 3. Is there pain in the scar on examination?
|
|
;;
|
|
;;
|
|
;; 4. Is there adherence to underlying tissue?
|
|
;;
|
|
;;
|
|
;; 5. Texture of skin. If irregular, atrophic, shiny, scaly, etc.,
|
|
;; give MEASUREMENT of length and width of area so affected.
|
|
;;
|
|
;;
|
|
;; 6. Is the scar unstable, meaning is there frequent loss of
|
|
;; covering of skin over the scar, such as from ulceration or
|
|
;; breakdown of skin?
|
|
;;
|
|
;;
|
|
;; 7. Is there elevation or depression of the surface contour
|
|
;; of the scar on palpation?
|
|
;;
|
|
;;
|
|
;; 8. Is the scar superficial (meaning there is no underlying
|
|
;; soft tissue damage)?
|
|
;;
|
|
;;
|
|
;; 9. Is the scar deep (meaning there is underlying soft tissue
|
|
;; loss or damage)? If yes, give MEASUREMENT of length and
|
|
;; width of underlying soft tissue damage.
|
|
;;
|
|
;;
|
|
;; 10. Describe any inflammation, edema, or keloid formation.
|
|
;;
|
|
;;
|
|
;; 11. Describe color of scar compared to normal areas of skin
|
|
;; (give MEASUREMENT of length and width of any hypopigmentation
|
|
;; or hyperpigmentation).
|
|
;;
|
|
;;
|
|
;; 12. For face, discuss whether there is gross distortion or
|
|
;; asymmetry of any feature or set of paired features (nose,
|
|
;; chin, forehead, eyes (including eyelids), ears (auricles),
|
|
;; cheeks, lips).
|
|
;;
|
|
;;
|
|
;; 13. Is there an area of induration and inflexibility of skin in
|
|
;; the area of the scar? If so, give MEASUREMENT of length
|
|
;; and width of area of induration.
|
|
;;
|
|
;;
|
|
;; 14. Describe any limitation of motion or other limitation of
|
|
;; function caused by a scar.
|
|
;;
|
|
;;
|
|
;; 15. With disfigurement or disfiguring scar of head, face, or
|
|
;; neck, submit COLOR PHOTOGRAPHS.
|
|
;;
|
|
;;D. Diagnostic and Clinical Tests:
|
|
;;
|
|
;; Include results of all diagnostic and clinical tests conducted
|
|
;; in the examination report.
|
|
;;
|
|
;;
|
|
;;E. Diagnosis:
|
|
;;
|
|
;;
|
|
;;Signature: Date:
|
|
;;END
|