Original Reports

Skin Color Match in Head and Neck Reconstructive Surgery

Corresponding Author

Philip Daniel Knott MD

[email protected]

orcid.org/0000-0002-8986-5961

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

Send correspondence to Philip Daniel Knott, MD, Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2233 Post Street, Room 361, San Francisco, CA 94115. E-mail: [email protected]

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Sean A. Alemi MD,

Sean A. Alemi MD

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Mary Han BA,

Mary Han BA

orcid.org/0000-0002-5585-0913

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Rahul Seth MD,

Rahul Seth MD

orcid.org/0000-0003-2775-530X

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Andrea M. Park MD,

Andrea M. Park MD

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Chase M. Heaton MD,

Chase M. Heaton MD

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Roy C. Grekin MD,

Roy C. Grekin MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Sarah T. Arron MD-PhD,

Sarah T. Arron MD-PhD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Isaac Neuhaus MD,

Isaac Neuhaus MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Siegrid S. Yu MD,

Siegrid S. Yu MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Drew K. Saylor MD,

Drew K. Saylor MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Bovey Z. Zhu MD,

Bovey Z. Zhu MD

Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.

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Philip Daniel Knott MD,

Corresponding Author

Philip Daniel Knott MD

[email protected]

orcid.org/0000-0002-8986-5961

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Sean A. Alemi MD,

Sean A. Alemi MD

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Mary Han BA,

Mary Han BA

orcid.org/0000-0002-5585-0913

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Rahul Seth MD,

Rahul Seth MD

orcid.org/0000-0003-2775-530X

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Andrea M. Park MD,

Andrea M. Park MD

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Chase M. Heaton MD,

Chase M. Heaton MD

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.

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Roy C. Grekin MD,

Roy C. Grekin MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Sarah T. Arron MD-PhD,

Sarah T. Arron MD-PhD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Isaac Neuhaus MD,

Isaac Neuhaus MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Siegrid S. Yu MD,

Siegrid S. Yu MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Drew K. Saylor MD,

Drew K. Saylor MD

Department of Dermatology, University of California, San Francisco, California, U.S.A.

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Bovey Z. Zhu MD,

Bovey Z. Zhu MD

Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.

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First published: 14 December 2021

https://doi.org/10.1002/lary.29959

Citations: 4

Editor's Note: This Manuscript was accepted for publication on November 6, 2019.

This manuscript is an accepted Triological Society Thesis.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

To quantify the degree of color match achieved during microvascular facial reconstruction, and to describe a novel technique for improving reconstructive skin color match. We hypothesize that split-thickness skin grafts (STSG) placed atop de-epithelialized free tissue produces better facial skin color match than free tissue with intact epithelium.

Study Design

Cross sectional photographic study of reconstructed facial skin color match.

Methods

Sixty-eight adults, who underwent head and neck reconstructive surgery, were divided into six categories based on cutaneous reconstructive technique: cervicofacial flap, radial forearm free flap (RFFF), fibula free flap, anterolateral thigh free flap (ALT), STSG over adiopofascial flap (STAFF), and STSG over myogenous flap (STMF). Averaged color samplings of the reconstructed defect and adjacent normal skin were taken from digital photographs. The color difference was calculated using the delta-E calculation. Blinded expert observers also rated the degree of color match. Nonparametric cohort contrast and correlation statistical analyses were performed.

Results

The mean delta-E's and 10-point Likert ratings for the ALT, fibula, RFFF, STAFF, STMF, and cervicofacial flaps were 11.6, 10.0, 7.7, 6.3, 8.8, and 4.7, and 5.1, 6.4, 2.4, 3.2, 2.7, and 1.1, respectively. Likert scale inter-rater correlation was strong, with coefficient = 0.80.

Conclusions

On average, STSG over de-epithelialized myogenous and adipofascial free tissue transfers produced a better color match than the skin paddles of donor sites, with the exception of the radial forearm donor site. Delta-E values obtained from photos correlated well with expert ratings of color match. This reliable technique for quantifying color match may be used in future studies.

Level of Evidence

3 Laryngoscope, 132:1753–1759, 2022

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Volume132, Issue9

September 2022

Pages 1753-1759

Skin Color Match in Head and Neck Reconstructive Surgery

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

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Skin Color Match in Head and Neck Reconstructive Surgery

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

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