Through a New Lens: Skin-Grafted Free Flaps and Objective Facial Skin Color Matching.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Aesthetic Medicine

Background:

• Head and neck ablative surgery often results in aesthetic disfigurement due to skin color mismatch.
• Objective assessment of facial skin color matching in reconstruction remains a challenge.

Purpose of the Study:

• To objectively measure skin color match outcomes following head and neck reconstruction using handheld colorimetry.
• To evaluate the efficacy of split-thickness skin grafts (STSGs) in improving facial skin color.

Main Methods:

• A cohort of 47 patients undergoing complex head and neck reconstruction with facial skin involvement was studied.
• Split-thickness skin grafts (STSGs) were applied over de-epithelialized myocutaneous or adipofasciocutaneous free flaps.
• Skin color match, quantified by deltaE values, was measured using a handheld colorimeter during follow-up.

Main Results:

• Patients receiving STSGs demonstrated significantly better color match (lower deltaE values) compared to those with unaltered skin paddles (3.4 ± 1.0 vs. 6.5 ± 2.5, p < 0.0001).
• The anterolateral thigh flap was the most common type used in this cohort.
• Twenty patients in the study received STSGs to the skin paddle.

Conclusions:

• The application of STSGs over de-epithelialized flaps is an effective method for improving skin color match in head and neck reconstruction.
• Handheld colorimetry provides an objective measure for assessing aesthetic outcomes in reconstructive surgery.
• Optimizing skin color match can significantly reduce aesthetic disfigurement after ablative surgery.