• Thomas D Dobbs, John A G Gibson, Sarah Hughes, Arron Thind, Benjamin Patel, Hayley A Hutchings, and Iain S Whitaker.
• From the Reconstructive Surgery and Regenerative Medicine Research Group, the Patient and Population Health and Informatics, Institute of Life Science 2, Swansea University Medical School; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital; the Abertawe Bro Morgannwg University Health Board, Princess of Wales Hospital; and Oxford University Medical School.
• Plast. Reconstr. Surg. 2019 Jan 1; 143 (1): 255-268.

BackgroundA patient's health-related quality of life can be significantly impacted by facial scarring and disfigurement. Facial soft-tissue reconstruction should aim to improve this, with outcomes measured from the patient's perspective using patient-reported outcome measures. This systematic review identifies patient-reported outcome measures for soft-tissue facial reconstruction and appraises their methodologic and psychometric properties using up-to-date methods.MethodsA systematic search of the MEDLINE, Embase, PsychINFO, and Cochrane databases was performed. Identified patient-reported outcome measures were assessed using the updated Consensus-Based Standards for the Selection of Health Measurement Instruments checklist. Psychometric properties were also assessed and a modified Grading of Recommendation Assessment, Development and Evaluation analysis was performed to aid in recommendations for future questionnaire use.ResultsThirty-four studies covering nine patient-reported outcome measures were included. Methodologic quality and psychometric evidence were variable. FACE-Q, Skin Cancer Index, Patient Outcome of Surgery-Head/Neck, and the Derriford Appearance Scale 59/24 all demonstrated high enough evidence to be recommended as having potential for inclusion in future studies.ConclusionsThis is the first systematic review to identify and critically appraise patient-reported outcome measures for soft-tissue facial reconstruction using internationally accepted criteria. Four questionnaires were deemed to have adequate levels of methodologic and psychometric evidence, although further studies should be conducted before they are used routinely in patients undergoing facial reconstruction. Through the use of psychometrically well-validated questionnaires, it is hoped that patients' concerns can be truly appreciated, the level of care improved, and the quality of reconstructive options offered advanced.

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