Colorimetric Evaluation of Facial Skin and Free Flap Donor Sites in Various Ethnic Populations

Abstract

To determine the optimal colour match for free tissue donor sites transferred to defects of the cheek and neck in a multicultural population. A prospective measurement of the colour of potential free flap donor sites and recipient sites in healthy volunteers. A tertiary care academic health science centre. Sixty-four healthy volunteers (Caucasian, black, South Asian, Southeast Asian) underwent noninvasive skin colour measurement of the cheek and neck, as well as a standard set of potential free tissue donor sites using a Minolta CR 300 (Konica-Minolta Canada; Markham, ON, Canada) chromameter. Measurement was done using derived colour measurements based on the Commission Internationale de l'Eclairage or International Commission on Light (CIE) L*a*b* tristimulus values. E* is a derived value of colour difference between sites using the L*a*b* measures. Statistical analysis was done using the Wilcoxon signed rank test. Variations exist between optimal donor sites in individuals of different ethnic backgrounds. Mean E* values suggest that in Caucasians, Southeast Asians, and South Asians, the upper extremity and trapezius flaps most closely approximate the recipient sites. In blacks, the variation in mean E* values is small and a wide variety of flaps provide a colour match to the cheek and neck. Luminance values support the observations regarding E*. Wide variations exist between individuals of different ethnic backgrounds in terms of optimal donor sites for the best colour match to surgical defects of the cheek and neck. In Caucasians, it appears that upper extremity sites, including the forearm and lateral arm flaps, provide the best colour match. Similar observations can be made in South Asians and Southeast Asians, with upper extremity flaps providing the best colour match. In blacks, there does not seem to be much variation in colour across the commonly used donor site, and a larger panel of flaps will provide an appropriate colour match in this subset of patients.