Colorimetric Examination of Typical Free Flap Donor Sites and Comparison to Recipient Sites in the Extremities

Abstract

Results after free flap reconstruction in the extremities are often impaired by missing color match of the transferred flap and the recipient site. But pre-existing color match is the precondition for satisfying aesthetic results. To obtain suitable free flap donor sites in terms of color for extremity reconstruction and to understand frequent color mismatch, we performed a colorimetric study including 60 healthy volunteers. Ten free flap donor sites were compared with ten recipient sites in the extremities. The results of our study showed that lower extremity sites are markedly lighter than upper extremity sites with the exception of the palmar forearm. We encountered an excellent color match of the radial forearm flap to the back of the hand (4.10 ± 1.91) and the palm of the hand (5.62 ± 2.21), and significantly relevant color match to the palmar aspect of the forearm (2.52 ± 1.23). Additionally, the lateral arm flap showed a remarkable color match to the dorsal aspect of the forearm (3.13 ± 2.06). Furthermore we encountered significantly relevant color match of the fibula flap to the anterior aspect of the lower leg (2.01 ± 1.08) and excellent color match of the anterolateral thigh flap (ALT) to the palmar aspect of the forearm (3.66 ± 2.10). No further significantly relevant color differences between the other donor sites and recipient regions were found. Colorimetric measurements are a helpful tool in reconstructive surgery to compare skin color of different anatomic sites.

Keywords

colorimetry - skin color - extremity reconstruction

• References

• 1 Harvey RG. Ecological factors in skin color variation among Papua New Guineans. Am J Phys Anthropol 1985; 66: 407-416
• 2 Spurgeon JH, Meredith HV, Onuoha GB. Skin color comparisons among ethnic groups of college men. Am J Phys Anthropol 1984; 64: 413-418
• 3 Westerhof W, van Hasselt BA, Kammeijer A. Quantification of UV-induced erythema with a portable computer controlled chromameter. Photodermatol 1986; 3: 310-314
• 4 Seitz JC, Whitmore CG. Measurement of erythema and tanning responses in human skin using a tri-stimulus colorimeter. Dermatologica 1988; 177: 70-75
• 5 Rubegni P, Cevenini G, Sbano P , et al. Cutaneous colorimetric evaluation of serum concentrations of bilirubin in healthy term neonates: a new methodological approach. Skin Res Technol 2005; 11: 70-75
• 6 Park SB, Suh DH, Youn JI. A long-term time course of colorimetric evaluation of ultraviolet light-induced skin reactions. Clin Exp Dermatol 1999; 24: 315-320
• 7 Barbini P, Cevenini G, Rubegni P , et al. Instrumental measurement of skin colour and skin type as risk factors for melanoma: a statistical classification procedure. Melanoma Res 1998; 8: 439-447
• 8 Andreassi L, Flori L. Practical applications of cutaneous colorimetry. Clin Dermatol 1995; 13: 369-373
• 9 Ngo K, Goldstein D, Neligan P, Gilbert R. Colorimetric evaluation of facial skin and free flap donor sites in various ethnic populations. J Otolaryngol 2006; 35: 249-254
• 10 Geishauser M, Schmiedl S, Staudenmaier R, Radl B, Biemer E. [Color comparison of donor sites of free flaps and the face]. Handchir Mikrochir Plast Chir 2000; 32: 166-171 German.
• 11 Rubegni P, Cevenini G, Stanghellini E , et al. A new device for objective assessment of skin type in Caucasians by violet light reflectance. Int J Cosmet Sci 2002; 24: 187-193
• 12 Coessens B, Van Geertruyden J, De Mey A. Surgical tattooing as an aesthetic improvement in facial reconstruction with a free radial forearm flap. J Reconstr Microsurg 1993; 9: 331-334
• 13 Yamamoto Y. Colorimetric evaluation of skin color in the Japanese. Plast Reconstr Surg 1995; 96: 139-145
• 14 Van den Kerckhove E, Staes F, Flour M, Stappaerts K, Boeckx W. Reproducibility of repeated measurements on healthy skin with Minolta Chromameter CR-300. Skin Res Technol 2001; 7: 56-59
• 15 Ha S, Lee M, Lee O , et al. A study of a method for distribution analysis of skin color. Skin Res Technol 2009; 15: 200-213
• 16 Anderson RR, Parrish JA. The optics of human skin. J Invest Dermatol 1981; 77: 13-19
• 17 Alaluf S, Heath A, Carter N , et al. Variation in melanin content and composition in type V and VI photoexposed and photoprotected human skin: the dominant role of DHI. Pigment Cell Res 2001; 14: 337-347
• 18 Kim MS, Rodney WN, Cooper T, Kite C, Reece GP, Markey MK. Towards quantifying the aesthetic outcomes of breast cancer treatment: comparison of clinical photography and colorimetry. J Eval Clin Pract 2009; 15: 20-31
• 19 Alaluf S, Heinrich U, Stahl W, Tronnier H, Wiseman S. Dietary carotenoids contribute to normal human skin color and UV photosensitivity. J Nutr 2002; 132: 399-403
• 20 Szabo G. The number of melanocytes in human epidermis. BMJ 1954; 1: 1016-1017
• 21 Staricco RJ, Pinkus H. Quantitative and qualitative data on the pigment cells of adult human epidermis. J Invest Dermatol 1957; 28: 33-45
• 22 Krackowizer P, Brenner E. Thickness of human skin-24 points of measurement. Phlebologie 2008; 37: 83-92