Wang Ji-ping, Fan Jin-cai, Chai Jia-ke
Burns Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China.
Zhonghua Shao Shang Za Zhi. 2009 Dec;25(6):411-4.
To study the effect of the technique of synchronously perforating and transplanting hair follicular-units in the treatment of cicatricial alopecia after burn.
One hundred and sixty-six patients with 217 bald scar areas after burn were treated with above-mentioned technique from January 2002 to April 2008. Scalp strips, with conforming the necessity for grafting, were harvested from the occipital or temporal region. A series of follicular-units, each composing 1 - 3 hairs, were dissected from the strips under microscope or magnifying glass. Size-matching micro-slots were made in the scarred recipient area with 16 - 20 G needles to accept the grafts. The prepared follicular-unit was synchronously implanted into the bottom of the micro-slot as the needle being withdrawn. Patients who were not satisfactory with the density of hairs after I stage surgery underwent II stage surgery a half year later. Ten recipient areas with clear boundary in 10 patients were optionally chosen to observe the density of follicular-units and hair amount with naked eyes after I stage surgery. Survived transplanted hairs in above-mentioned 10 areas were counted to calculate hair survival rate at follow-up. Patients' postoperative satisfaction ratings were surveyed with questionnaire.
In one half of the patients, treatment was finished after I stage surgery, the other one half received 2 stages of surgery. The follicular-unit density reached 15 - 25 grafts/cm(2) with 40 - 70 hairs/cm(2) after I stage surgery. All patients were followed up for over 8 months. Grafted hairs grew well in a natural way. 96.5% mean hair survival rate was observed in the 10 recipient areas. From patients who received only I stage surgery, 61 patients (73.5%) were very satisfactory and 22 patients (26.5%) satisfactory with the results. From the other half of patients, 76 patients (91.6%) were very satisfactory and 7 patients (8.4%) satisfactory with the results.
The technique of perforating and transplanting follicular-unit hair synchronously is safe and effective with less surgery-induced injury and less bleeding. Hairs transplanted on cicatricial alopecia area with this technique grow well with high survival rate.
探讨同步打孔移植毛囊单位技术治疗烧伤后瘢痕性秃发的效果。
2002年1月至2008年4月，采用上述技术治疗166例烧伤后有217处秃发瘢痕区的患者。从枕部或颞部切取符合移植需要的头皮条。在显微镜或放大镜下从头皮条上分离出一系列由1 - 3根毛发组成的毛囊单位。用16 - 20G针头在瘢痕受区制作大小匹配的微槽以接纳移植体。在针头退出时将制备好的毛囊单位同步植入微槽底部。Ⅰ期手术后对毛发密度不满意的患者半年后行Ⅱ期手术。随机选取10例患者的10个边界清晰的受区，观察Ⅰ期手术后肉眼可见的毛囊单位密度和毛发数量。对上述10个区域存活的移植毛发进行计数以计算随访时的毛发成活率。采用问卷调查患者术后的满意度评分。
一半患者Ⅰ期手术后治疗结束，另一半患者接受了2期手术。Ⅰ期手术后毛囊单位密度达15 - 25个移植体/cm²，毛发密度达40 - 70根/cm²。所有患者随访8个月以上。移植毛发自然生长良好。10个受区平均毛发成活率为96.5%。仅接受Ⅰ期手术的患者中，61例（73.5%）对结果非常满意，22例（26.5%）满意。另一半患者中，76例（91.6%）对结果非常满意，7例（8.4%）满意。
同步打孔移植毛囊单位毛发技术安全有效，手术创伤小、出血少。采用该技术移植到瘢痕性秃发区的毛发成活率高、生长良好。
