New devices for scalp reduction. Intraoperative and prolonged scalp extension.

BACKGROUND: Scalp reduction for male pattern and other extensive, permanent crown-vertex alopecias has been a beneficial, adjuvant procedure in hair replacement surgery and has been augmented by unsightly and sometimes painful intraoperative and chronic scalp expansion techniques. METHODS: Ten patients underwent scalp reduction for male pattern baldness utilizing intraoperative Sure-Closure, a skin-stretching device. Ten patients had Frechet Extenders placed under the scalp during their scalp reductions with subsequent removal 28 days later followed immediately by second reduction procedures. RESULTS: The skin-stretching device, Sure-Closure, allowed the excision of 20%-30% more alopecic scalp during scalp reduction than what would have been possible with scalp reduction alone. The Frechet Extender when combined with a lazy S excision pattern for scalp reduction procedures generated between 25% and 50% more excision of alopecic scalp than with scalp reduction alone. CONCLUSION: Scalp reduction procedures can be more effectively performed with minimal complications and fewer reductions required per patient using either intraoperative scalp extension with the Sure-Closure device or chronic scalp extension with the Frechet Extender.

Halsey needle holder for micro and mini slit grafting.

BACKGROUND: Few suggestions have been made to date concerning how to more reproducibly place scalp slits for micro- and minigrafts. OBJECTIVE: To improve on the unpredictable consistency of depth and angle of scalp slits for micro- and minigrafting. METHOD: Seven-inch Halsey needle holders were used to stabilize the cutting instruments (No-Kor microblades, #15c, and #15 blades) for making scalp slits for micro- and minigrafts on approximately 80 patients over 5 months. CONCLUSION: Using the Halsey needle holder or stabilization of the blades for slit placement of scalp micro- and minigrafting is superior to directly holding the blades by improving on depth, angle control, ease of holding and adjustment, and greater reproducibility.

Blue rubber bleb nevus syndrome: laser photocoagulation of colonic hemangiomas in a child with microcytic anemia.

This is a case report and review of the literature on the blue rubber bleb nevus syndrome. The clinical features of the syndrome are discussed, with emphasis on chronic gastrointestinal bleeding and resulting anemia. A new therapeutic modality, colonoscopy with laser photocoagulation, is recommended as a safe, effective, and less invasive method of controlling bleeding from colonic hemangiomas than surgical resection and repeated transfusions. This technique is less helpful for patients with prominent involvement of the small intestine.