Fitzpatrick R E
Dermatology Associates of San Diego County, Inc., Encinitas, CA 92024, USA.
Dermatol Surg. 1995 Dec;21(12):1042-6.
Micro- and minigrafting have become increasingly popular in hair transplantation over the past decade, resulting in larger numbers of grafts per session and lengthy, potentially technically difficult procedures. The advent of very high energy pulsed carbon dioxide lasers as surgical instruments has led to the investigation of their use in hair transplantation, as bloodless surgery with tissue removal by vaporization has obvious advantages as far as surgical speed is concerned.
A prospective study of eight patients comparing conventional micro- and minigrafting using 18- and 14-gauge needle punctures with dilators versus laser-vaporized donor sites with variation of laser parameters was conducted with monthly evaluation of healing and hair growth for 6 months. In addition, an in vitro histological study of laser vaporization recipient sites on excised scalp tissue was conducted to evaluate the residual thermal damage of various laser parameters.
The conventional micro- and minigrafts healed faster and resulted in better hair growth than the laser vaporization sites. The donor sites were judged to be comparable as far as healing, but more time consuming with the laser. The operative time for the laser recipient sites was 50% of that of the conventional sites.
The clinical results of laser hair transplantation are very dependent upon the laser parameters and technique used. Though operative time may be significantly reduced, the end result clinically is dependent on proper choices of pulse parameters and technique.
在过去十年中,微小移植和迷你移植在毛发移植中越来越受欢迎,导致每次手术移植的毛囊数量增多,手术过程冗长且可能在技术上具有挑战性。极高能量脉冲二氧化碳激光作为手术器械的出现引发了对其在毛发移植中应用的研究,因为就手术速度而言,通过汽化去除组织的无血手术具有明显优势。
对8名患者进行了一项前瞻性研究,比较了使用18号和14号带扩张器的穿刺针进行传统微小移植和迷你移植与改变激光参数对供体部位进行激光汽化的效果,每月评估愈合情况和毛发生长情况,持续6个月。此外,对切除的头皮组织上的激光汽化受体部位进行了体外组织学研究,以评估各种激光参数下的残余热损伤。
传统微小移植和迷你移植的愈合速度比激光汽化部位更快,毛发生长也更好。就愈合情况而言,供体部位被认为相当,但激光操作更耗时。激光受体部位的手术时间是传统部位的50%。
激光毛发移植的临床结果非常依赖于所使用的激光参数和技术。虽然手术时间可能会显著缩短,但临床最终结果取决于脉冲参数和技术的正确选择。