Fragility of grafts... especially FUE.

[hairtech]

Follicular grafts are highly susceptible to drying out and dying. In a manner of a few seconds they can be bone dry when left without droplets of saline, blood or other media to protect them. I have witnessed some clinics placing large groups of grafts on their fingers during implantation and putting them at risk for drying out (dessication).

There are a plethora of ways to keep the grafts hydrated while implanting. Below is an example of one. The use of a finger cup to submerge the grafts prior to implantation. I personally put a few on my fingertip before implanting right next to the cup... but making sure the grafts are wet. The ones here on my fingertip will be implanted quickly before the next group.


These are FUE grafts.

 

[Prohairclinic]

Good post.
This also explains why training Implanters take time and patience. They MUST work slow.

Experienced technicians can handle grafts smoothly, gently and place them back into the skin very quickly without damage.

Although speed is not always an argument, in this case handling fast the grafts from drying out is key.

Bart

 

[Bigmac]

Nice post.

 

[DHI]

The most important factor for the preservation of the extracted hair follicles is keeping them moist rather than in cold environment. Even in these conditions the grafts should not exceed staying out of the recipient skin for more than 4 hours, since scientific papers have shown that their survival tends to decrease after this time period.
DHI pays great attention and practices strict protocols on this issue. The hair follicle grafts are kept in moist conditions right from the moment they are extracted from the skin because they are placed on moist gauze. Apart from that DHI is currently using HypoThermosol as a special biopreservation solution in an effort to ensure the survival of the grafts 100% since saline is shown to provoke cell swelling which leads the newly implanted hair follicles to a premature telogen phase and hair shedding.

 

[hairtech]

"...since saline is shown to provoke cell swelling which leads the newly implanted hair follicles to a premature telogen phase and hair shedding."
DHI,
Where did you find this data? I have never heard of this. *nl

 

[hairtech]

Addendum DHI,

I also threw this question to Dr. Josephitis from SMG just in case I was missing something...


He confirmed that this statement:

"... since saline is shown to provoke cell swelling which leads the newly implanted hair follicles to a premature telogen phase and hair shedding." wasn't something he had heard before either.

Anyway, Saline is used in thousands of clinics around the world and the properties of physiological saline does not provoke cell swelling. However there can be a Ph change after several hours but this alone is not necessarily going to make cells swell. The reason why I know this is because I participated and co-published at one of the ISHRS conferences many years back a Ph study with different media (including saline) and changing several variables such as , time, temperature and petri dishes with and without grafts, etc.

Needless to say, the Ph increased (became acidic) over time, with higher temperatures, and with grafts within the petri dishes.

By the way, we have been using hyperthermosol for at least 3 years. It is a better Ph stabilizer even than saline alone. However no one can guarantee a 100% yield based only on using hyperthermosol.



c;;9

 

[Prohairclinic]

Hi Hairtech,interesting discussion.
would you happen to have a study between saline and [hyperthermosol?

 

[DHI]

Hello Hairtech,

Well, nobody says that saline is not in use in various clinics as a preservation media. We have been using it as well until recently. Ringer €™s lactate is another media in use. The thing is that under the magnification lenses that we use for the grafts €™ recognition, we noticed that when using HypoThermosol there was no such cell swelling like the one that we have been noticed when using plain saline. You can yourself apreciate the action of the certain solution by checking the company's site.

Another factor that leads to the conclusion that most possibly the biopreservation solution is a better preservation media than plain saline, is the fact that when using HypoThermosol we have noticed significantly lower percentage of implanted hair follicles that pass to premature telogen phase some days after the procedure than the one noticed when using saline.

In fact we are concluding a certain experimental protocol in which we shall compare the effects on the implanted hair follicles when using Hypothermosol, Ringer €™s lactate and plain Saline as a grafts €™ preservation solution. We will let you know as soon as we have the data.

 

[hairtech]

would love to see the protocol and methods of the experiments and control group.
cheers

 

[DHI]

We will keep you posted. Thank you Hairtech.
Cheers

 

[hairtech]

DHI,

When are you starting this study? ¬b`

 

[DHI]

After noticing the positive effects on the premature hair loss from the implanted follicles in a 8 months duration, we started officially the protocol in September.

 

[Bigmac]

It would be good to see the findings when this study is complete.