Arguing the Ethics of Facial Transplantation

Alexander, Ashlin J.; Alam, Daniel S.; Gullane, Patrick; Lengelé, Benoît; Adamson, Peter A.

doi:10.1001/archfaci.2009.106

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…16 The increased risk of malignancy associated with the need for life-long immunosuppression, however, eliminates its use for all patients with head and neck cancer. 17 While skin color match has received relatively little attention in the head and neck cancer reconstructive literature, it has been a focus of research within the cervicofacial burn literature. 18 Plastic surgeons have explored the option of full and STSG's, and have evaluated the color match associated with skin grafts placed over microvascular muscle flaps.…”

Section: Discussionmentioning

confidence: 99%

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Skin Color Match in Head and Neck Reconstructive Surgery

et al. 2021

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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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Section: Discussionmentioning

confidence: 99%

“…This technique has been applied with some degree of success to patients suffering severe facial disfigurement related to gun‐shot wounds, trauma, and facial burns 16 . The increased risk of malignancy associated with the need for life‐long immunosuppression, however, eliminates its use for all patients with head and neck cancer 17 …”

Section: Discussionmentioning

confidence: 99%