Umar Sanusi, Shitabata Paul, Rose Paul, Carter Marissa J, Thuangtong Rattapon, Lohlun Boudine, Benhiba Hind, Oguzoglu Tayfun, Zollinger Maria Marta, Maldonado Juan, Gonzalez Alejandro, Novosilska Myroslava, Gómez Zubiaur Alba, Marti Miguel
Department of Medicine, Dermatology Division, University of California, Los Angeles, CA, USA.
Division of Dermatology, Harbor-UCLA Medical Center, Torrance, CA, USA.
Clin Cosmet Investig Dermatol. 2022 Jun 27;15:1133-1147. doi: 10.2147/CCID.S369346. eCollection 2022.
The difficulty of the follicular unit excision (FUE) hair transplantation procedure is currently attributed to hair curliness and subsurface angulation. Patients possessing the curliest hair shafts are considered the most challenging. Consequently, patients with these features are often denied FUE. However, this practice does not consider intrapatient variation in the graft attrition rate and the rates themselves, which are frequently low in very curly hair where the skin firmness/thickness is average. To better aid practitioners in predicting FUE performance, we have developed a new scoring system (the Sanusi FUE Score Scale [SFS Scale]) based on two major donor variables (hair and skin characteristics).
The scale assigns scores to each of three hair subtypes (straight-wavy, curly, and coily-kinky) and each of three skin subtypes (thick/firm, soft/thin, and medium thickness/firmness). The scores were weighted based on the assessment of 13 experienced FUE practitioners from around the globe, who were asked to score each of the three skin and hair characteristics for their contribution to FUE difficulty.
On the contribution of skin characteristics to FUE difficulty, 12/13 (92%) practitioners assigned the highest (most difficult) score to thick/firm skin, with medium skin thickness/firmness being the least challenging. The same percentage of practitioners gave the highest difficulty score to coiled-kinky hair subtypes regarding the contribution of hair characteristics to FUE difficulty. All agreed that straight-wavy hair presents the least challenge to FUE performance. Tallying the scores of the skin and hair variables generates a final score range of 2-9, which is associated with five grades/classes of challenge in the FUE procedure, influencing the need for a specialized skill/nuanced approach or equipment.
We developed a universal FUE donor scoring scale that accounts for the diversity of human hair and skin types. Further evaluation to determine the validity of this new classification system in predicting and grading FUE difficulty and patient outcomes is warranted.
目前，毛囊单位提取（FUE）毛发移植手术的难度归因于头发的卷曲度和皮下角度。拥有最卷曲发干的患者被认为是最具挑战性的。因此，具有这些特征的患者往往被拒绝接受FUE。然而，这种做法没有考虑患者内部移植物损耗率的差异以及损耗率本身，在皮肤硬度/厚度平均的非常卷曲的头发中，损耗率通常很低。为了更好地帮助从业者预测FUE的效果，我们基于两个主要的供体变量（头发和皮肤特征）开发了一种新的评分系统（萨努西FUE评分量表[SFS量表]）。
该量表为三种头发亚型（直-波浪状、卷曲状和螺旋-纠结状）以及三种皮肤亚型（厚/硬、软/薄和中等厚度/硬度）分别打分。这些分数是根据对来自全球的13位经验丰富的FUE从业者的评估进行加权的，他们被要求对三种皮肤和头发特征对FUE难度的贡献进行评分。
关于皮肤特征对FUE难度的贡献，13位从业者中有12位（92%）将最高（最难）分数分配给厚/硬皮肤，中等皮肤厚度/硬度的挑战性最小。同样比例的从业者在头发特征对FUE难度的贡献方面，将最高难度分数给到螺旋-纠结状头发亚型。所有人都认为直-波浪状头发对FUE手术的挑战性最小。将皮肤和头发变量的分数相加得出最终分数范围为2至9分，这与FUE手术中五个挑战等级相关，影响对专业技能/细致方法或设备的需求。
我们开发了一种通用的FUE供体评分量表，该量表考虑了人类头发和皮肤类型的多样性。有必要进行进一步评估，以确定这种新的分类系统在预测和分级FUE难度以及患者预后方面的有效性。
