source: FOIAVistA/trunk/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCWSW1.m@ 1094

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1DVBCWSW1 ;ALB/CMM SCARS WKS TEXT - 1 ; 6 MARCH 1997
2 ;;2.7;AMIE;**12**;Apr 10, 1995
3 ;
4 ;
5TXT ;
6 ;;A. Review of Medical Records:
7 ;;
8 ;;
9 ;;
10 ;;B. Medical History (Subjective Complaints):
11 ;;
12 ;; 1. Type of injury or infection causing the wound or scar, its
13 ;; date, the treatment used and the response to such treatment.
14 ;;
15 ;;
16 ;; 2. Current symptoms.
17 ;;
18 ;;
19 ;;C. Physical Examination (Objective Findings):
20 ;;
21 ;; Address each of the following and fully describe current findings
22 ;; (for each scar):
23 ;; 1. Location, measurements (cm. x cm.), and shape of each scar.
24 ;;
25 ;;
26 ;; 2. Tenderness.
27 ;;
28 ;;
29 ;; 3. Adherence.
30 ;;
31 ;;
32 ;; 4. Texture.
33 ;;
34 ;;
35 ;; 5. Ulceration or breakdown of skin.
36 ;;
37 ;;
38 ;; 6. Elevation or depression of scar.
39 ;;
40 ;;
41 ;; 7. Extent of underlying tissue loss.
42 ;;
43 ;;
44 ;; 8. Inflammation, edema, or keloid formation.
45 ;;
46 ;;
47 ;; 9. Color of scar compared to normal areas of skin.
48 ;;
49 ;;
50 ;; 10. Disfigurement.
51 ;;
52 ;;
53 ;; 11. For each burn scar, state if due to a 2nd or 3rd degree burn.
54 ;;
55 ;;
56 ;; 12. Limitation of function by scar.
57 ;;
58 ;;
59 ;; 13. An attachment is provided in the Handout of Instructions for
60 ;; Compensation and Pension Examinations for plotting the
61 ;; location of scars.
62 ;;
63 ;;
64 ;;D. Diagnostic and Clinical Tests:
65 ;;
66 ;; 1. With disfigurement or disfiguring scar of head, face, or neck,
67 ;; submit COLOR PHOTOGRAPHS.
68 ;; 2. Include results of all diagnostic and clinical tests conducted
69 ;; in the examination report.
70 ;;
71 ;;
72 ;;E. Diagnosis:
73 ;;
74 ;;
75 ;;Signature: Date:
76 ;;END
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