Vancouver Scar Scale (VSS)

When it activates

Scribeable activates a calculator from the encounter. The Vancouver Scar Scale (VSS) can activate when the transcript or pasted chart context documents any of these:

• Scar assessment
• Burn scar evaluation
• Surgical scar monitoring
• Hypertrophic scar treatment
• Keloid assessment
• Scar revision planning

Inputs the note needs

4 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.

Scoring

Vascularity (0-3) + Height (0-3) + Pliability (0-5) + Pigmentation (0-3) = Total 0-14.

Interpretation

Score <5: Good scar — minimal intervention needed, continue maturation monitoring. Score 5-9: Moderate scarring — consider silicone sheeting, compression therapy, corticosteroid injection, laser therapy. Score >=10: Poor/severe scarring — aggressive management with combination therapy (intralesional steroids, silicone, pressure, laser, possible surgical revision). Individual parameters guide targeted treatment: high vascularity → pulsed dye laser; height/pliability → intralesional triamcinolone + pressure; pigmentation → sun protection + bleaching agents or laser. Re-assess every 2-3 months. Most scars mature over 12-18 months.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Sullivan 1990.

• Sullivan T et al. Rating the burn scar (Vancouver Scar Scale)Sullivan et al. (Vancouver Scar) 1990 · 1990 · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Vancouver Scar Scale (VSS) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.

The score is computed in code from the resolved inputs, not recalled by the language model. A stated Vancouver Scar Scale (VSS) value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

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Can activate in: Surgery, Dermatology, Plastic & Reconstructive Surgery, Physical Medicine & Rehabilitation.