Keck School of Medicine of USC, University of Southern California, 1510 San Pablo Street, Suite 415, Los Angeles, CA, 90033, USA.
Department of Plastic and Reconstructive Surgery, Keck Hospital of USC, University of Southern California, 1510 San Pablo Street, Suite 415, Los Angeles, CA, 90033, USA.
Aesthetic Plast Surg. 2020 Feb;44(1):97-113. doi: 10.1007/s00266-019-01529-9. Epub 2019 Oct 30.
The decision of surgical approach for hair restoration often involves evaluation of the type of alopecia; however, the impact of surgical hair restoration from existing techniques in specific population subsets has not been comprehensively investigated.
The authors sought to systematically review the literature on micrografts, minigrafts, mini-micrografts, tissue grafts, tissue flaps and expanders, as well as evaluate graft survival and satisfaction within specific populations in a meta-analysis.
PubMed and Scopus literature searches between 1980 and 2018 yielded 57 articles for systematic review and 34 articles for meta-analysis. Study design, mean patient age and gender, patient alopecia type, surgical hair restoration technique, number of treatment areas, mean follow-up, graft survival rate and satisfaction rate were extracted from each study, and a meta-analysis was performed.
The pooled rates of graft survival were 84.98% (95% CI 78.90-91.06) using micrografts and 93.11% (95% CI 91.93-94.29) using micrografts and minigrafts in nonscarring alopecia patients, as well as 88.66% (95% CI 80.12-97.20) using micrografts and 86.25% (95% CI 74.00-98.50) using micrografts and minigrafts in scarring alopecia patients. The pooled rates of satisfaction were 89.70% (95% CI 82.64-96.76) using micrografts and 97.00% (95% CI 92.48-100.0) using micrografts and minigrafts in nonscarring alopecia patients, as well as 97.80% (95% CI 94.59-100.0) using micrografts and 88.70% (95% CI 66.49-100.0) using micrografts and minigrafts in scarring alopecia patients. Dot plots depict rates of graft survival rate from micrografts and satisfaction from micrografts and minigrafts.
Surgical hair restoration for nonscarring and scarring alopecia yields high graft survival and satisfaction rates.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
毛发修复手术方法的选择通常需要评估脱发类型；然而，现有技术在特定人群亚组中的应用效果尚未得到全面评估。
作者旨在通过系统评价，对微移植、微皮片、微小皮片、组织移植、组织皮瓣和扩张器等技术进行文献回顾，并评估其在特定人群中的移植成活率和满意度。
通过对 1980 年至 2018 年期间的 PubMed 和 Scopus 文献进行检索，对 57 篇文章进行系统评价，对 34 篇文章进行荟萃分析。从每项研究中提取研究设计、患者平均年龄和性别、患者脱发类型、毛发修复手术技术、治疗区域数量、平均随访时间、移植成活率和满意度等数据，并进行荟萃分析。
非瘢痕性脱发患者中，微移植和微皮片的移植成活率为 84.98%（95%CI 78.90-91.06），微移植和微皮片联合应用的成活率为 93.11%（95%CI 91.93-94.29）；瘢痕性脱发患者中，微移植的成活率为 88.66%（95%CI 80.12-97.20），微移植和微皮片联合应用的成活率为 86.25%（95%CI 74.00-98.50）。非瘢痕性脱发患者中，微移植和微皮片联合应用的满意度为 89.70%（95%CI 82.64-96.76），微移植和微皮片联合应用的满意度为 97.00%（95%CI 92.48-100.0）；瘢痕性脱发患者中，微移植的满意度为 97.80%（95%CI 94.59-100.0），微移植和微皮片联合应用的满意度为 88.70%（95%CI 66.49-100.0）。散点图显示了微移植和微移植联合微皮片的移植成活率以及微移植联合微皮片的满意度。
非瘢痕性和瘢痕性脱发的毛发修复手术方法具有较高的移植成活率和满意度。
证据等级 III：本刊要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266。
