Necrosis Related to Chromatic Analysis of Median Forehead Flap

Objective: The current study was directed to analyze the vascularity of different parts of median forehead flaps using chromatic analyses. Patients and methods: Eight patients were included in the study. Following basal cell carcinoma resection, the median forehead flap was created. A high-resolution visible light photograph, including the flap and the adjacent donor site tissues, was captured. Split visible light color channels (Red, Green, and Blue) were measured for different regions of interest. The measured areas were the normal tissue, total flap, flap base, apex, margin, and flap center. Differences in visible color channels of these regions were calculated. The flap's dimensions were measured, including flap length, base width, and apex width. Flap base width to flap length and flap apex width to flap base width ratios were calculated. In the first postoperative month, another photograph was taken to measure the flap necrosis percentage at the reconstruction site. The relation of the flap necrosis percentage with the calculated differences and ratios was estimated.Results: There were strong significant correlations between flap necrosis percentage and the difference between flap base and flap apex red and green channels’ values, flap base width to flap length ratio, and flap base width to flap apex width ratio. Significant practical differences existed between the flap base to apex and the flap center to margins RGB channels.Conclusion: To the limitation of the current study, the reduction of flap apex width and flap length relative to flap base width reduces flap necrosis percentage.