InCISE: Instrument for Comprehensive Incisional and Surgical Evaluation

Amy Anne D Lassig, Bruce R. Lindgren, Anna C. Wilson, Anne M Joseph, Mark Davison, Bevan Yueh

Research output: Contribution to journalArticlepeer-review


Objective: The evaluation of healing after head and neck surgery is currently qualitative and non-standardized, limiting the quality of surgical healing assessments in clinical and research settings. We sought to develop an objective, standardized wound assessment score, and hypothesize that a reliable instrument can be developed to evaluate head and neck surgical wounds. Methods: A prospective cohort study was conducted in a tertiary-care, academic head and neck surgery practice. Patients undergoing head and neck surgery were enrolled. A digital photograph protocol was developed for evaluating healing surgical wounds. A panel of experts developed and refined a wound healing score and established reliability, reproducibility, internal consistency, and validity of the score. Results: InCISE: Instrument for comprehensive incisional and surgical evaluation was created. The utility of our wound healing score was assessed using classical test theory. We performed the major steps of establishing reliability in head and neck surgeons: (1) internal consistency (Cronbach's α = 0.81), (2) inter-observer reliability (intra-class correlation = 0.76), and (3) intra-rater reliability (intra-class correlation = 0.87), and content validity (through focus groups). Our composite measure was found to have strong internal consistency, inter-rater reliability, and intra-rater reliability. Preliminary work suggests criterion validity via associations with physical health related quality of life (SF-12). Conclusion: A wound healing score for head and neck surgery, InCISE, has been developed and is reliable, reproducible, and consistent. Although content validity is present and criterion validity is suggested, work continues to establish validity in this instrument to allow for expanded clinical and research use. Level of Evidence: NA Laryngoscope, 133:2166–2173, 2023.

Original languageEnglish (US)
Pages (from-to)2166-2173
Number of pages8
Issue number9
StatePublished - Sep 2023

Bibliographical note

Funding Information:
This work was funded by Hennepin Healthcare Research Institute Career Development Award; NIH grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota; National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR002494.

Publisher Copyright:
© 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.


  • head neck
  • instrument
  • score
  • surgery
  • wound healing

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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