Objective Skin Quality Assessment after Reconstructive Procedures for Facial Skin Defects

Area of Science:

• Plastic Surgery
• Dermatology
• Regenerative Medicine

Background:

• Local random skin flaps and skin grafts are common reconstructive techniques.
• Long-term outcomes of these methods for skin defects remain unclear.
• Objective evaluation is needed to assess post-operative skin quality.

Purpose of the Study:

• To objectively evaluate the long-term (over one year) skin quality outcomes of local random flaps versus split-thickness skin grafts (STSGs) and full-thickness skin grafts (FTSGs).
• To compare reconstructed facial areas with healthy contralateral sides using non-invasive measurement devices.

Main Methods:

• 31 facial defects reconstructed with local random flaps, 30 with STSGs, and 30 with FTSGs were included.
• Skin quality was assessed using MP6 non-invasive probes measuring melanin, erythema, hydration, sebum, friction, and transepidermal water loss (TEWL).
• Objective measurements were compared between reconstructed sites and healthy contralateral facial sides.

Main Results:

• Local random flaps showed no significant difference in skin quality parameters compared to the healthy contralateral side.
• FTSGs and STSGs exhibited significantly higher TEWL and erythema.
• FTSGs and STSGs displayed significantly lower hydration, sebum, and friction levels compared to the contralateral side.
• STSGs also showed a significant difference in melanin count.

Conclusions:

• Random local flaps result in better long-term skin quality outcomes than skin autografts for facial reconstruction.
• The complex wound-healing process after random flap use may lead to superior skin quality.
• Random local flaps are recommended for facial defect reconstruction whenever feasible.