Measurements of tension on wound edges after strip harvest surgery

The measurement of wound tensile strength and the effect of PRP on wound tensile force: an experimental investigation on rabbits

Platelets in PRP are used for their functions in the initiation and regulation of the wound healing process and are used for the repair of injured tissues and the rejuvenation of healthy tissues. In this study, we evaluated the effect of a single dose platelet-rich plasma on skin wound healing and we demonstrated the effect of platelet-rich plasma on skin wound healing by measuring changes in the wound tensile strength.Material and methods: A total of 8 incisions, each 3 cm long, were made on the back skin on both sides of the vertebral column of 12 rabbits. After suturing their backs with staples, platelet rich plasma (PRP) was injected into the edges of the wounds on the left side and saline solution (saline) was injected into the edges of the wounds on the right side. The tensile force that causes wounds to rupture by applying tension was measured on the 7th, 14th, 21st, and 28th days with the help of a special home-designed device.Results: The mean PRP enrichment was 3.19 fold over peripheral blood. The saline to PRP tensile strength ratios on the 7th, 14th, 21st, and 28th days were calculated as 75.7%, 104.0%, 105.3% and 86.5%, respectively. Overall, the difference in the tensile strength for wounds that had received saline or PRP was in-significant.Conclusion: The application of PRP increases the tensile strength of the wound in the early period. It is possible to measure the tensile strength precisely in in vivo studies with economical home-designed devices.

Vertical or horizontal scalp mobility: What to assess

BACKGROUND

Scalp is comprised of five layers namely skin, connective tissue, aponeurosis, loose areolar tissue, and periosteum, each having distinct characteristics. The scalp mobility plays an important role in scalp wound closure. Thus, the estimation of scalp mobility is necessary to obtain a tension-free closure and fine scar in hair restoration surgery.

AIMS

To know the difference of available number of FUs while using two different scalp mobility methods, that is, horizontal vs vertical methods.

PATIENTS/METHODS

The study was conducted in a private hair restoration clinic in the patients undergoing surgery after taking informed consent from all the patients. Any patient with a previous scalp surgery was excluded. The horizontal mobility was calculated using Mayer's method, and the vertical mobility was calculated using Mohmand 7 Ahmad's method on the same areas. All the data were recorded and analyzed statistically using Mann-Whitney test.

RESULTS

A total of 15 patients were included in the study. The average length of the strip was 24.7 cm (range; 20-29 cm) with hair density of 138.1 cm² (range; 114-195.7 cm² ). The average strip width was found to be 17.1 mm by using horizontal mobility scale and 19.6 mm by using vertical scalp mobility. The horizontal scale resulted in average strip area of 42.0 cm² as compared to average area of 49.1 cm² by using vertical scale. The average number of hair by horizontal scale was calculated to be 5792.8 hairs and 6762.5 hairs by using vertical mobility scale (P < .05). The average number of more hair to be available by using vertical scale was 969.7.

CONCLUSION

The vertical scale resulted in more number of hair from the donor strip in the same patient.

The Battle begins: Is strip surgery really necessary?

OBJECTIVES

To measure the effects of previous Follicular Unit Transplantation (FUT) procedure.

MATERIALS AND METHODS

The study was conducted in a private hair transplant clinic after obtaining informed consent. Only those patients were included who had a previous strip harvest surgery (FUT) and opted for Follicular Unit Excision/Extraction (FUE) procedure. In all the patients, the donor hairs were trimmed to about 1-2 mm length. The width of the scar, the hair density above and below the scar, and hair angles above and below the scar were measured. All the patients underwent FUE procedure using 0.9 mm serrated punch. Twenty attempts were made above and below the scar (about 0.5 cm), and the total number of hair and transections was measured. All the data were analyzed statistically.

RESULTS

Ten patients were included. The average width of the scar was 2.47 mm. The mean hair density was found to be 155.4 hairs per cm² above the scar and 130.8 per cm² below the scar. The mean hair angle was found to be 28.21 degrees above the scar and 39.19 degrees below the scar in midline occipital above the scar (P < .05). The average hair count was found to be 49.8 hairs above the scar and 47.2 hairs above the scar (P < .05). The transection of hair was doubled below the scar (P < .05) CONCLUSION: The Follicular Unit Transplantation (FUT) procedure does leave some impacts on the donor area other than the scar only. The change in angle results in higher transection of hair above the scar.