Skin color matching in vascularized composite allotransplantation (VCA) is an important determinant of aesthetic outcomes. The Pantone SkinTone Guide (PSTG) is a handheld tool comprising realistic skin tone swatches with a corresponding virtual swatch system. A color match acceptability threshold (AT) is defined as the point beyond which >50% of observers deem a given skin tone pairing as unacceptable. 

In a study published in PRS Global Open, color match acceptability thresholds were developed using the PSTG to help standardize donor-recipient color matching. 

Here, four representative colors were chosen across the skin tone spectrum. These standard colors were used to develop a survey asking participants to determine the acceptability of color pairings. Using survey results, ATs were determined for changes in lightness, undertone and lightness and undertone combined for each of the standard colors. Inter- and intra-rater reliability were determined using Fleiss’s Kappa.

It was observed that participants were more critical of skin tone pairings on the darker versus the lighter end of the spectrum – as evidenced by higher thresholds observed for lighter sample pairs. Additionally, observers were more critical of differences in skin lightness compared with differences in undertone. Intra-rater reliability was fair to substantial, while inter-rater reliability was fair to moderate. 

It was inferred that the PSTG can be used as a clinical tool to improve the aesthetic outcomes of skin-containing VCA procedures by optimizing donor-recipient skin color matching. This tool augments current methods by covering a broad spectrum of skin colors and assigns a numerical code to each tone.This can allow clinicians to complement visual judgment with quantitative reference.

Source: PRS Global Open. 2020 Feb; 8(2): e2655. Published online 2020 Feb6. doi: 10.1097/GOX.0000000000002655