Evidence map›Paper›PMID 41257399›Full record

ArticleThe Laryngoscope2026

EPIDERM Technique: Safety and Outcomes of Skin Grafted Free Flaps in Head and Neck Reconstruction.

Nina Patel, Nicole Reynoso, Chase Heaton, Ilya Likhterov, Mary Xu, Katherine Wai, Aarti Agarwal, Neil Patel, Andrea Park, P Daniel Knott

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Nina PatelDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
Nicole ReynosoDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.ORCID 0009-0001-1143-1290
Chase HeatonDivision of Oncologic Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
Ilya LikhterovDivision of Oncologic Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
Mary XuDivision of Oncologic Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.ORCID 0000-0002-4996-6362
Katherine WaiDivision of Oncologic Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.ORCID 0000-0001-8180-4542
Aarti AgarwalDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
Neil PatelDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.ORCID 0000-0003-1365-9130
Andrea ParkDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
P Daniel KnottDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.ORCID 0000-0002-8986-5961

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWhile prior studies have demonstrated favorable aesthetic outcomes using skin grafted free flaps to improve recipient site color match (Epithelial Preservation Including Dermal Resection Microvascular technique: EPIDERM technique), the clinical safety of this approach has not been established. Manipulation of the skin paddle potentially impairs free tissue monitoring and therefore may affect success rates. This study aims to compare perioperative outcomes in patients undergoing head and neck free flap reconstruction with and without the EPIDERM technique.

methodsA retrospective 1:1 matched cohort study was conducted involving 138 patients who underwent free flap reconstruction between January 2022 and December 2024 at a single tertiary care center. Patients were matched by flap type to control for variations in reconstructive technique and defect site. Data collected included demographics, defect characteristics, flap type, operative time, perioperative complications, reoperations, and hospital length of stay.

resultsDefect distribution differed between groups, with scalp defects more common in the EPIDERM group (p = 0.05) and oropharyngeal and mandibular defects more frequent in the standard group (p < 0.01, p = 0.02). Despite these differences in defect distribution, no significant differences were observed in flap viability, wound complications, reoperation rates, hospital readmissions, or length of hospital stay between the color match and non-color match groups.

conclusionThe EPIDERM technique represents a safe adjunct to head and neck free flap reconstruction, offering the potential for improved aesthetic outcomes with no apparent increase in perioperative risk or morbidity. LEVEL OF EVIDENCE: 3:

Indexed as

Free Tissue FlapsHead and Neck NeoplasmsPlastic Surgery ProceduresSkin TransplantationAdultAgedFemaleHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsReoperationRetrospective StudiesTreatment Outcomeaesthetic outcomescolor match techniquesde‐epithelialized flapEPIDERM techniquefree flap reconstructionhead and neck reconstructionmicrosurgical reconstructionperioperative complicationssplit‐thickness skin graft

Identifiers

PMID41257399
PMCPMC12993096

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.