MacLennan S E, Kitzmiller W J, Mertens D, Warden G D, Neale H W
Department of Surgery at the University of Cincinnati College of Medicine, Shriners Hospital for Children-Cincinnati Burns Hospital, Ohio 45267, USA.
Plast Reconstr Surg. 1998 Nov;102(6):1865-8. doi: 10.1097/00006534-199811000-00009.
Hair transfer from split-thickness skin grafts harvested from the scalp is not a widely reported problem. The authors present their experience with hair transfer from scalp autografts in a pediatric burn population, with particular emphasis on hair transfer to the face. They retrospectively reviewed 3307 acute and reconstructive pediatric burn admissions over a 4-year period at a single institution and identified 109 cases in which the scalp had been used as a donor site and in which the patient survived the acute burn period. Data from 73 male and 36 female patients were analyzed with respect to age, race, sex, percent total body surface area burned, graft thickness, number of scalp harvests and time between harvests, and presence of donor site alopecia. Eighteen of the 109 patients had noticeable hair growth from their scalp grafts (17 percent). Fourteen of 18 cases of hair growth involved face or neck grafts (13 percent); the remaining 4 patients had hair growth elsewhere on the body. There was no difference between the two groups (hair growth versus no hair growth) when compared by age, sex, or graft thickness. There was a correlation between larger burn size and greater incidence of hair growth. Those who had multiple harvests of the same scalp donor site were more than twice as likely to have hair transfer (9 of 34 versus 9 of 75 patients), although time between harvests was not a significant variable. Caucasian children represented 77 percent of the study population yet 100 percent of the cases of problem hair growth. Thirty-three percent of the hair growth group (6 of 18 patients) and 4 percent of the remaining patients (4 of 91) had some degree of donor site alopecia. The scalp is a reliable and valuable donor site for skin grafting in children, particularly for facial burns. The authors note a moderate incidence of hair transfer (17 percent) and propose both suggestions for prevention and recommendations for management.
从头皮获取的中厚皮片发生毛发移植并非一个被广泛报道的问题。作者介绍了他们在小儿烧伤患者中进行头皮自体移植毛发移植的经验，尤其着重于毛发移植到面部的情况。他们回顾性分析了一家机构在4年期间收治的3307例小儿急性和重建性烧伤患者，确定了109例将头皮用作供区且患者度过急性烧伤期存活的病例。对73例男性和36例女性患者的数据进行了分析，涉及年龄、种族、性别、烧伤总面积百分比、移植皮片厚度、头皮取材次数和取材间隔时间以及供区脱发情况。109例患者中有18例（17%）头皮移植处有明显毛发生长。18例毛发生长病例中有14例（13%）涉及面部或颈部移植；其余4例患者身体其他部位有毛发生长。按年龄、性别或移植皮片厚度比较，两组（有毛发生长与无毛发生长）之间无差异。烧伤面积较大与毛发生长发生率较高之间存在相关性。同一头皮供区多次取材的患者发生毛发移植的可能性是其他患者的两倍多（34例中有9例，而75例中有9例），尽管取材间隔时间不是一个显著变量。白人儿童占研究人群的77%，但问题毛发生长病例占100%。毛发生长组的33%（18例中有6例）和其余患者的4%（91例中有4例）有一定程度的供区脱发。头皮是儿童皮肤移植可靠且有价值的供区，尤其是对面部烧伤而言。作者指出毛发移植发生率适中（17%），并提出了预防建议和处理建议。
