Measurement of the Skin Color Changes of Free Flaps by Chromometry

Lim, Joong Jae; Son, Dae Gu; Choi, Dong Won; Han, Ki Hwan

Abstract

The distant free flaps have become the first choice for large, complex, complicated wounds. The skin of free flaps maintains its original color and texture with little or no change, but even these can develop some abnormal pigmentation and distant tissue does not match with recipient sites skin in color, texture, or thickness. To evaluate color changes of transferred flaps and color match with recipient sites in free flaps, we used Minolta chromameter with a L, a, b, color space recommmended by the CIE(Commission International de l'Eclairage). Eighteen patients(12 males and 6 females) who had undergone various free flap surgeries participated in the present study. The used free flaps included 5 first webspace free flaps or great toe free transfers, 5 free transverse rectus abdominis myocutaneous flaps, 2 free dorsalis pedis flaps, 2 free latissimus dorsi myocutaneous flaps, 2 free gracilis myocutaneous flaps, 2 free lateral arm flaps. The recipient sites for reconstruction were hand(n = 7), forearm(n = 4), lower leg(n = 3), foot(n = 2), breast(n = 2). In the 1st, 3rd, 6th, and 12th month after surgery, time-related colorimetric changes of the first webspace free flaps or great toe free transfers for thumb and first webspace reconstruction(n=5) showed a decrease in L(lightness). The a(redness), b(yellowness) value of the flap were not significantly changed. The skin color changes of the transferred flaps to sun unexposed recipient sites(breast) were less than those to sun exposed recipient sites(hand, forearm, lower leg). These indicate probably because of the greater quantity of pigment in sun exposed skin flaps. Also,in total color difference of the transferred flaps and recipient sites, free transverse rectus abdominis myocutaneous flaps for breast reconstruction was lower than the other flaps. Measuring skin color of the planned flap and recipient site before surgery and management of sunlight exposure of the recipient site are very helpful guides to obtain a good color match in reconstructive surgery.