ABSTRACT
BACKGROUND: Follicular Unit Extraction (FUE) is considered to be a minimally invasive procedure, and the injury to the donor area caused by a sharp punch may result in dermal fibrosis and clinically observed hypopigmentation. OBJECTIVE: To evaluate with advanced image processing the efficacy of using 0.9% normal saline in minimizing the injury to the donor area in FUE donor harvesting. PATIENTS AND METHODS: The term acute extraction (AE) is used to describe the donor harvesting technique, whereby a follicular unit (FU) is removed with a punch that is aligned parallel with the exit angle of the hair follicle. The term vertical extraction (VE) describes the technique where a FU is removed in like manner, but normal saline is injected intradermally prior to harvesting so the punch being perpendicular to the skin. Thirty-five patients were selected for this study to apply both harvesting techniques and then to compare the differences in wound surface size and skin mass removed by the punch. RESULTS: A significant reduction in the mean values of wound surface and skin mass was recorded in vertical extraction compared to those in acute extraction. CONCLUSION: The injection of normal saline prior to harvesting proved to be very efficient in minimizing skin injury in FUE harvesting.
Subject(s)
Hair Follicle/transplantation , Sodium Chloride/administration & dosage , Surgical Wound/prevention & control , Tissue and Organ Harvesting/adverse effects , Tissue and Organ Harvesting/methods , Transplant Donor Site/injuries , Adult , Cicatrix/etiology , Cicatrix/prevention & control , Cosmetic Techniques/adverse effects , Humans , Hypopigmentation/etiology , Hypopigmentation/prevention & control , Image Processing, Computer-Assisted , Injections, Intradermal , Middle Aged , Photography , Surgical Wound/diagnostic imaging , Surgical Wound/etiology , Transplant Donor Site/diagnostic imaging , Young AdultABSTRACT
PURPOSE: We prospectively compared buccal mucosa graft and lingual mucosa graft urethroplasty with respect to donor site morbidity and urethroplasty outcome. MATERIALS AND METHODS: Patients treated with buccal mucosa graft (29) or lingual mucosa graft (29) urethroplasty were included in the study. Oral pain and morbidity were assessed using the numeric rating scale (scale 0 to 10) as well as an in-home questionnaire administered 3 days, 2 weeks and 6 months postoperatively. RESULTS: After a mean (± SD) followup of 30 (± 13) months successful urethroplasty was achieved in 24 (82.8%) and 26 (89.7%) patients treated with buccal mucosa graft and lingual mucosa graft, respectively (p = 0.306). Median numeric rating scale after 3 days, 2 weeks and 6 months was 4, 2 and 0 for buccal mucosa graft and 6, 3 and 0 for lingual mucosa graft, respectively, with no statistical differences between the groups. At day 3 significantly more patients in the lingual mucosa graft group had severe difficulties with eating and drinking (62.1% vs 24.1%, p = 0.004) and speaking (93.1% vs 55.2%, p = 0.001), and had dysgeusia (48.3% vs 13.8%, p = 0.01). Two weeks postoperatively speech impairment was still more frequent with lingual mucosa graft (55.2% vs 13.8%, p = 0.002), whereas oral tightness was more frequent with buccal mucosa graft (41.4% vs 6.9%, p = 0.005). After 6 months 44.8% and 31% of patients treated with buccal mucosa graft and lingual mucosa graft, respectively, still reported sensitivity disorders (p = 0.279). CONCLUSIONS: The success of urethroplasty with lingual and buccal mucosa grafts was similar. Oral pain was not different after both grafts. In the early postoperative period there were differences in oral morbidity between buccal and lingual mucosa grafts. Long-term oral morbidity was not infrequent with both grafts.
