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[自体毛发移植后脱发患者专用保护帽的设计与临床应用]

[Design and clinical application of specialized protective cap for patients with alopecia after autologous hair transplantation].

作者信息

Li M F, Gu L, Wang L, Dai J J, Yang X K, Guan H, Han J T, Hu D H

机构信息

Department of Burns and Cutaneous Surgery, Burns Center of PLA, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2020 Sep 20;36(9):865-869. doi: 10.3760/cma.j.cn501120-20190815-00352.

Abstract

To investigate the design of specialized protective cap for patients with alopecia after autologous hair transplantation and its application value in nursing care after autologous hair transplantation. The author designed a kind of specialized protective cap for patients with alopecia after autologous hair transplantation with elastic gauze, fiber, silica gel, and other materials. It was divided into two parts, the front piece was mainly used to protect the hair receiving site, and the back piece was mainly used for pressure hemostasis at the hair donor site. From February 2017 to January 2019, 81 patients with alopecia and had autologous hair transplantation in the First Affiliated Hospital of Air Force Military Medical University, who met the inclusion criteria, were enrolled in this prospective controlled study. According to the tail number of admission number of each patient, 43 patients with odd numbers were recruited in protective cap group (38 males and 5 females, aged 23 to 52 years) and 38 patients with even numbers were recruited in convention group (34 males and 4 females, aged 22 to 55 years). After hair transplantation surgery, patients in the two groups received routine postoperative education. Patients in the conventional group were treated with conventional dressing after surgery. On this basis, patients in protective cap group wore the specialized protective caps for at least 1 week continuously except for necessary dressing change, wound clean, and dressing remove. The follow-ups was performed by responsible doctors and nurses at clinic. The postoperative hemorrhage at the hair donor site on post surgery day (PSD) 3 and swelling of scalp at the surgical site on PSD 7, the folliculitis at the hair receiving site and survival condition of transplanted hair follicle at the receiving site, and satisfaction score within 3 months after surgery were observed and recorded. Data were statistically analyzed with two independent sample test, chi-square test, and Fisher's exact probability test. (1) On PSD 3, one patient in protective cap group had hemorrhage at the hair donor site, which was significantly less than 8 patients in convention group (<0.05). (2) On PSD 7, 4 patients in protective cap group had swelling of scalp at the surgical site, which was significantly less than 11 patients in convention group ((2)=5.160, <0.05). (3) Within 3 months after surgery, 0 patient in protective cap group had folliculitis at the hair receiving site, which was less than 3 patients in convention group. (4) In 3 months after surgery, the survival number of hair follicle in each 100 transplanted hair follicles at the hair receiving site of patients in protective cap group was 94.9±2.8, which was significantly more than 91.1±4.7 in convention group (=4.354, <0.01). (5) The patients' satisfaction score in protective cap group was (14.2±2.6) points, which was significantly higher than (12.1±3.0) points in convention group (=3.338, <0.01). After autologous hair transplantation, the specialized protective cap can reduce postoperative hemorrhage at the hair donor site, swelling of scalp at the surgical site, as well as improve the survival rate of transplanted hair follicles at the hair receiving site and score of patient satisfaction.

摘要

探讨自体毛发移植术后脱发患者专用保护帽的设计及其在自体毛发移植术后护理中的应用价值。作者采用弹力纱布、纤维、硅胶等材料设计了一种自体毛发移植术后脱发患者专用保护帽。该保护帽分为两部分,前片主要用于保护毛发植入区,后片主要用于供发区压迫止血。选取2017年2月至2019年1月在空军军医大学第一附属医院行自体毛发移植术且符合纳入标准的81例脱发患者,进行此项前瞻性对照研究。根据患者入院序号尾数,将奇数尾号的43例患者纳入保护帽组(男38例,女5例,年龄23~52岁),偶数尾号的38例患者纳入常规组(男34例,女4例,年龄22~55岁)。毛发移植术后,两组患者均接受常规术后宣教。常规组患者术后采用常规换药。在此基础上,保护帽组患者除必要的换药、伤口清洁及拆除敷料外,连续佩戴专用保护帽至少1周。由责任医生和护士在门诊进行随访。观察并记录术后第3天供发区出血情况、术后第7天术区头皮肿胀情况、毛发植入区毛囊炎情况及植入区移植毛囊存活情况,以及术后3个月内的满意度评分。数据采用两独立样本t检验、χ²检验及Fisher确切概率法进行统计学分析。(1)术后第3天,保护帽组有1例患者供发区出血,明显少于常规组的8例患者(P<0.05)。(2)术后第7天,保护帽组有4例患者术区头皮肿胀,明显少于常规组的11例患者(χ²=5.160,P<0.05)。(3)术后3个月内,保护帽组毛发植入区无毛囊炎发生,少于常规组的3例。(4)术后3个月,保护帽组患者毛发植入区每100个移植毛囊存活数为94.9±2.8个,明显多于常规组的91.1±4.7个(t=4.354,P<0.01)。(5)保护帽组患者满意度评分为(14.2±2.6)分,明显高于常规组的(12.1±3.0)分(t=3.338,P<0.01)。自体毛发移植术后,专用保护帽可减少供发区术后出血、术区头皮肿胀,提高毛发植入区移植毛囊存活率及患者满意度评分。

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