All authors are affiliated with the Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University Guangzhou, Guangdong Province, China.
Dermatol Surg. 2023 Jul 1;49(7):675-681. doi: 10.1097/DSS.0000000000003799. Epub 2023 Apr 7.
Hair transplantation has become a popular choice for alopecia treatment; however, postsurgical hair shedding still annoys both patients and surgeons.
To explore the impact of graft-holding solution on postsurgical hair shedding and testify the protective efficacy of histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine (HTK-AD).
There were 240 patients enrolled in the study, and the follicles were placed into either HTK-AD or Ringer solution (RS). Masson staining and live/dead staining were performed to evaluate graft morphology and apoptosis levels, respectively. The between-group comparison of postsurgical graft shedding, survival rate, complications, and patient satisfaction was performed.
Grafts in HTK-AD maintained organized dense collagen construction and higher cell viability, but those preserved in RS became soft, which hindered implantation. Histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine significantly reduced the incidence of postsurgical hair shedding (73.81% vs 95%), delayed shedding onset, and diminished shedding amount versus RS ( p < .05) when ≥3,000 grafts were transplanted. The shedding duration was shortened, and hair regrowth started earlier in HTK-AD versus RS ( p < .05); thus, satisfaction was increased. The final survival rate showed no difference between 2 groups.
Histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine is superior to RS for hair graft preservation because it improves graft viability and alleviates postsurgical shedding.
毛发移植已成为治疗脱发的一种流行选择；然而，术后脱发仍然困扰着患者和外科医生。
探讨移植物保存液对术后脱发的影响，并验证含三磷酸腺苷和去铁胺的组氨酸-色氨酸-酮戊二酸溶液（HTK-AD）的保护作用。
本研究纳入 240 例患者，将毛囊分别置于 HTK-AD 或林格氏液（RS）中。分别采用 Masson 染色和活/死染色评估移植物形态和细胞凋亡水平。对术后移植物脱落、成活率、并发症和患者满意度进行组间比较。
HTK-AD 保存的移植物保持着有组织的密集胶原结构和更高的细胞活力，而 RS 保存的移植物则变得柔软，这阻碍了植入。当移植≥3000 个毛囊时，与 RS 相比，含三磷酸腺苷和去铁胺的组氨酸-色氨酸-酮戊二酸溶液显著降低了术后脱发的发生率（73.81%比 95%），延迟了脱发的开始时间，并减少了脱发量（p <.05）。与 RS 相比，HTK-AD 缩短了脱发持续时间，更早开始头发再生（p <.05），从而提高了患者满意度。两组的最终成活率无差异。
含三磷酸腺苷和去铁胺的组氨酸-色氨酸-酮戊二酸溶液在改善移植物活力和减轻术后脱发方面优于 RS，是一种更优的毛发移植移植物保存液。
