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How to improve graft survival in hair transplantation

Abstract

Despite improvements in hair transplantation, the results are not always satisfactory. The viability of grafts is one of the most challenging problems in hair transplantation. This is particularly important for mega sessions, when the time of maintenance of the follicles increases significantly.

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The purpose of our study was to evaluate the morphological changes of stitches and define the viability frames of follicles at different stages of hair transplantation.

The research into the true follicle structure in the electric microscope was carried out according to the mainstream method.

On the basis of the results presented, the timing of the different stages of hair transplantation can be maximized to increase the survival rate of grafts and to improve the effect of hair transplantation.

Introduction

The hair transplant is the only effective method to restore hair in the case of and alopecia. Its popularity has increased significantly in recent years; hence the number of hair transplant specialists has increased. Over the past 15 years, hair transformation has changed from a simple procedure 1-2 times, in the micro-congenital exercise 5-10 times very difficult, when hundreds and sometimes thousands of graft can be transplanted. It requires the coordinated work of highly qualified staff. Despite improvements in hair transplantation, the results are not always satisfactory.

The viability of grafts is one of the most challenging problems in hair transplantation. This is particularly important for mega sessions, when more than 3,000 graft is transplanted during surgical intervention only, and the time associated with maintenance of the follicles increases significantly.

One of the main factors affecting the survival of grafts is the warming and dehydration of grafts. Graft conservation method is generally recognized by cooling them to + 4-5 ° С in saline solution or Ringer.

What happens in follicles during the maintenance? This is the question we would like to answer. For this reason we conducted original research.

The purpose of our study was to evaluate the morphological changes of stitches and define the viability frames of follicles at different stages of hair transplantation.

Content and methods

All patients entered in the study were transfused with an autistic hair transplant using a microfilm method using a strip technique. After leaking strip donor, the grafts were disposed of using stereoscopic microscopes, the prepared grafts were collected on a gauze container soaked in saline (25-30 graft per container) and kept in a refrigerator at + 4 – + 5 ° C) until they are placed in a recipient zone. During the implant the container was placed at the back of the surgeon’s hand. This is the classical work scheme used by most of the hair transplant specialists.

The morphological changes on the grafts (each containing 1-3 follicles) were studied on the preparatory table after 10-20 minutes, after preparation with the 2 minute periods. (30 graft studies were carried out). The grafts were studied in the process, they started from the 3rd minute after they are placed on the gloves with the periods 1 minute for 8 minutes (30 graft completely). The grafts were placed in the fridge for 2 to 24 hours.

The tissues were embedded and  cut and stained as half-thin slices for choice of region of interest. The selected sample areas for were then prepared following the traditional protocol and studied under a transmitted electron microscope.

Results

It has been shown that the cells of a germic zone follicles are well preserved in 10 minutes after their extinction in the grafts lying on the preparatory table at room temperature (22 °).

Poorly differentiated cells are kept, without separate distinguishing signs, well with large nuclei. Moderate amounts of organs. These cells are close to each other. The plasma membrane consists of contacts in the desmosomes type with a digital extension.

The dynamics of the gravity of the grafts, which are located on the preparatory board, have shown that after the container period there have been significant changes after the 12-minute ultra-structural level, and in 20 minutes the irreversible changes were noted, which means cellular death. These changes showed the rupture of cell membranes (plasma membranes were not visible), the destruction of cytoplasm organisms, chromatin pollution from nuclei.

Ceramic zone of the follicles 24 hours after it is inserted into the fridge.

The grafts, which were kept in a refrigerator at 4 – +5 ° C, showed perfect structural conditions during the first 3-4 hours, and a 24 hour viability rate was about 71%.

Conclusion

The study allowed electro microscopic condition of grafts to identify time frames that survive.

Leave time on the container during dissection _ no more than 10 minutes.

Theft at the time of the doctor’s hand during transplant   not more than 4 minutes (maximum 2-3 minutes).

The best time to keep the device in the fridge is 3-4 hours at + 4-5 ° С.

On the basis of the results presented, it can be determined that we can optimize the length of the different stages of hair transplantation. This will increase the survival rate of grading and improve the results of treatment.

For more information visit our website FUE Hair Transplant Lahore, Pakistan

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