Question no | Below average | Average | Good | Very good | Excellent | Total score (Out of 25) |
1 | 2 | 3 | 4 | 5 | ||
Are you satisfied by this scar |
|
|
|
|
|
|
Are you in need of change of the clothing style because of scar |
|
|
|
|
|
|
Has your daily manual work or duties influenced by the donor site |
|
|
|
|
|
|
Are you in need of applying special medication for donor site |
|
|
|
|
|
|
Is there problem to wear the ornaments or watch after operation on affected side |
|
|
|
|
|
|