Carolinas HealthCare System

In an effort to better evaluate and track the quality-of-life (QOL) for patients undergoing hernia surgery, CLASP physicians developed and patented the Carolinas Comfort Scale® (CCS).

This scale has been statistically validated against other well studied and validated assessment tools (SF-36) and is quickly becoming the gold standard for QOL assessments in hernia patients. With the use of mesh shown to considerably reduce recurrence rates for hernia repair and subsequent improvement in clinical outcomes, focus has now been placed on quality-of-life (QOL) outcomes in patients undergoing these repairs.

The CCS is being used all over the world to evaluate the quality of life of patients undergoing complex hernia repairs. The CCS is used by surgeons in 19 US states, 39 Countries, and has been translated into multiple languages.

Distinguished usage:

  • A physician from France will launch a research trial using the CCS involving 30 university hospital teams in France. The study is sponsored by the French government.
  • A physician from the United Kingdom will use the CCS in Nottingham City Hospital which covers 64 general practices and provides care to 330,000 patients annually. The CCS will be used as a support tool for screening eligibility for inguinal hernia repair surgery funded by the Nottingham City Hospital. To be eligible for National Health Service funding for hernia repair surgery, certain clinical thresholds are required, including hernia symptoms affecting activities of normal daily life. They will use the CCS system-wide as a measure of the impact of hernia surgery on activities of daily life to determine coverage.

View the Carolinas Comfort Scale® publication that came out in the Journal of the American College of Surgeons (PDF)

Use and Contact Information

The use of the CCS requires a License Agreement (LA) between Carolinas HealthCare System and the physicians or institutions that are interested in using the CCS in their practices, hospitals, or for their research studies. It is a simple agreement requiring a nominal, one-time administration fee per facility which the CCS will be used. The primary purpose of the LA is to ensure our Division is properly referenced if you should decide to present or publish CCS data.

For more information regarding the use of the CCS Please contact Dr. Amy Lincourt at

CCS World Usage

CCS World Usage