Validation of Fespixon in Postoperative Scar Cosmesis Using Quantitative Digital Photography Analysis

Abstract Background Unsightly scarring after surgery remains a dilemma. One of the challenges is the lack of objective scar assessment tools. Objectives This study aimed to evaluate the efficacy of a novel medicine, Fespixon, for prevention and/or alleviation of post-skin incision scar. The second aim was to demonstrate the practicality of our digital analysis system to see if it would serve as a sensitive tool for scar-improving assessment. Methods A prospective, placebo-controlled trial involving patients with postoperative transverse scars was conducted. Each patient received a topical formulation of Fespixon on the left scar, and placebo cream on the right scar. In addition to the subjective mVSS and VAS scores, we utilized digital photography for monthly scar analysis, with CIELab and hue serving as the colorimetric, and contrast, correlation, homogeneity, and entropy as texture information. Results Forty-six participants (mean age, 52 years) were enrolled in the trial. All the parameters of subjective assessment showed superior results for the Fespixon-treated side, with significant differences in pigmentation, vascularity, pliability, height, itchiness, and patient satisfaction (p = 0.043, 0.013, 0.026, 0.002, 0.039, 0.012, respectively). The trends of color and texture showed increased relative difference ratios, with significant differences in most of the eigenvalues towards the Fespixon-treated side, including the CIELab-L (p = 0.000), Hue-R, B, G (p = 0.034, 0.001, 0.011), contrast (p = 0.000), homogeneity (p = 0.000), correlation (p = 0.011), and entropy (p = 0.000). Conclusions We validated the efficacy of Fespixon in postoperative scar healing applications from not only subjective assessments but also with objective quantitative analyses. The results also indicated that our digital photographic quantitative analysis system is an ideal tool for quantification of scar appearance.