国人自体头发移植术的研究

自１９８８年９月至１９９２年１２月，共已施行９８０次自体头皮打孔皮片头发移植术，主要用于供区发源充沛的脂溢性秃发和瘢痕秃发者３９５例。根据国人的头发数量较白种人约少１／３，毛干呈直线型，以及头发与头皮色泽反差大等特点，采用了Ｌ形排列移植、圆皮片间插入半圆皮片，术后头皮文身及烫发等相应措施以提高疗效。并认为成人发适宜头发移植、而儿童则更适宜头皮扩张术。     

国人自体头发移植术的研究

自1988年9月至1992年12月,共已施行980次自体头皮打孔皮片头发移植术,主要用于供区发源充沛的脂溢性秃发和瘢痕性秃发者395例。根据国人的头发数量较白种人约少1/3,毛干呈直线型,以及头发与头皮色泽反差大等特点,采用了L形排列移植、圆皮片间插入半圆皮片,术后头皮文身及烫发等相应措施以提高疗效。并认为成人秃发适宜头发移植,而儿童则更适宜头皮扩张术。     

毛发移植术治疗秃发研究进展

雄激素源性秃发的治疗研究开展已有100余年历史，手术治疗方法很多，如钻孔头皮移植、条形头皮移植、头皮皮瓣转移、头皮扩张术及头皮缩减术等，这些手术移植物成活率高，但头发外观往往有失自然，甚至留下明显的瘢痕。20世纪80年代以后，随着器械和技术的革新，由于微小毛发皮片移植术的成功，使移植头发的形态有所改善。     

应用微小有发头皮片移植体治疗男性型秃发

目的 探讨使用微小有发头皮片移植术治疗男性型秃发的临床效果。方法 对18例男性型秃发患者进行22次自体微小有发头皮片移植术,其中16例进行1次移植,1例2次移植,1例4次移植。结果 12例术后随访6～9个月,外观较术前明显改善,无并发症发生。结论 应用微小有发头皮片移植治疗男性型秃发,术后移植头发存活率高,外观自然,但一次种植仍显稀疏,有时需2次或多次移植。     

微头皮条移植治疗秃发

目的 探讨采用微头皮条移植术，进行头发移植治疗秃发的效果及提高头发移植术后毛囊的存活率。方法 在局部肿胀麻醉下，对156例男性型秃发和瘢痕性秃发患者，施行了微头皮条移植术，并较早在国内与显微外科技术相结合。结果 男性型秃发和瘢痕性秃发患者，移植后毛囊的存活率平均分别是95％和89％，且效果稳定不再脱落；其中瘢痕性秃发患者毛囊的存活率为89％，明显高于以往报道的54％～76％。术后有2例患者发际形态不自然，4例受区中央部头发分布形态欠佳，2例出现小血肿，其余患者受区头发生长较为满意。结论 微头皮条移植结合显微外科技术，可明显提高毛囊移植的存活率；此外，适应证的选用、术前设计、麻醉的选用等，对手术效果也有较大影响。     

头皮扩张与自体头发移植术治疗瘢痕性秃发

目的：探讨一种有效治疗瘢痕性秃发的方法。方法：1993－1998年,收治多部位或大面积瘢痕性秃发21例,根据秃发部和面积的不同,对同一患者的瘢痕性秃发分别采用头发扩张与自体头发移植术（带毛囊皮条移植）进行治疗,共安放皮肤扩张器34枚,修复秃发的最大面积为340cm2,结果：无论秃发区面积的大小,或是鬓角,发际等特殊部位的秃发,术后创面愈合良好,秃发区均得较满意的修复,1个月后移植的带毛囊皮条基本成活,并可见毛发生长,本组术后发生扩张器外露1例,扩张失败1例,均及时取出处理,另有2例头发生长方向改变。结论：头皮扩张与自体头发移植术联合应用,是治疗多部位或大面积瘢痕性秃发较 理想的方法。     

儿童头皮扩张修复瘢痕性秃发

目的探索儿童瘢痕性秃发的修复方法。方法１９８８年２月～１９９８年２月共收治儿童因烧伤后致瘢痕性秃发４５例，采用软组织扩张器行头皮扩张修复秃发区。介绍了儿童头皮扩张的特点、方法及其手术原则。结果术后效果满意，随访到５例，随访时间１～２年，除毛发生长方向改变外，扩张区和正常区头发无明显差异。结论在烧伤瘢痕性秃发的修复方法中，应首选软组织扩张术。     

头发移植术后并发动静脉瘘的治疗

头发移植是以男性秃发患者为主的最常见的美容手术,其中打孔自体皮片移植是最简单最有效的方法,并发症少见报道。文献回顾目前国外有９例头发移植术后发生了动静脉瘘（Ａｒｔｅｒｉｏｖｅｎｏｕｓ Ｆｉｓｔｕｌａ简称ＡＶＦ）。其症状为在术后数周至数月在头皮任何区域出现的一个或整个异常隆起的肿块,有搏动、杂音等症状,甚至会引起出血、头皮坏死。有时有局部疼痛或头痛症状。文献中多见为发生于受区的ＡＶＦ。本文报道了我科     

头皮穿凿性毛囊炎的整形外科治疗

目的探讨应用整形外科技术治疗头皮穿凿性毛囊炎的临床效果。方法回顾性分析2019年2月至2021年12月兰州大学第二医院收治的头皮穿凿性毛囊炎患者的临床资料。根据患者病灶具体部位、范围及侵犯程度, 选择直接切除缝合或以局部皮瓣修复、切开引流彻底清创后延期缝合、将侵犯毛囊已形成秃发畸形的病灶彻底切除后移植皮片、在头皮下方彻底切除病灶后拉拢缝合等手术方法进行治疗。术后随访观察患者头部创面愈合及复发情况。结果共纳入7例患者, 均为男性, 年龄18～30岁;头顶部3例, 枕部2例, 项部2例;病灶范围3.0 cm×5.0 cm～14.0 cm×7.0 cm;病程6个月至10年。7例患者创面术后1～2周均一期愈合。随访3个月至3年, 所有患者术区均无复发。其中1例行皮片移植的患者, 皮片成活良好, 愈合后出现秃发, 其他部位有散在再发病灶;1例可见局部瘢痕增生;其余患者创面愈合良好, 头发生长均尚可, 对外观均满意。结论应用整形外科技术治疗头皮穿凿性毛囊炎, 周期较短, 效果较好。     

自体显微毛发单元移植治疗瘢痕性秃发

目的探索显微毛发单元移植治疗因各种原因引起的瘢痕性秃发的新技术。方法选择头部健康有浓密毛发的头皮为供区，切取含有完整头发的条形头皮组织，分割成显微毛发单元移植物，植入秃发区内预制的相应孔洞中。自2003年2月至2005年12月，应用该项技术治疗71例瘢痕性秃发患者。行工期手术成功治疗了52例患者，行Ⅱ期手术成功治疗了19例患者。结果术后随访患者6～12个月，移植的毛发生长自然、密集、发质良好，平均成活率为90％，外观效果均满意。结论显微毛发单元移植技术具有手术创伤小，恢复快，毛发生长自然、密集，发质良好等优点，是治疗瘢痕性秃发的一种较好的手术方法。     

高密度自体毛发移植治疗脂溢性秃发的疗效观察

目的 探讨应用高密度显微外科毛发移植技术,综合移植多种微小型毛胚,治疗脂溢性秃发的临床效果.方法 切取患者头发生长浓密的枕、颞部头皮作为毛发移植供体,5倍专用手术显微镜下分离毛囊,制成多种微小移植毛胚,以三棱针、微型刀片和卵圆形打孔器在受区打孔,用显微外科移植镊,由前向后顺序将移植毛胚植入受区孔隙,术后定期随访.结果 32例脂溢性秃发,移植毛发的平均成活率为90%,Ⅰ期手术后患者满意度为81%,6例不满意患者行Ⅱ期手术后均达到了满意的治疗效果.随访12～24个月,毛发生长自然、密集,发质良好无脱落.结论 应用高密度显微毛发移植技术,综合移植多种微小型毛胚,具有手术时间短、植发密度高、覆盖效果好等优点,大部分患者Ⅰ期手术后即可获得满意的治疗效果.     

高密度自体毛发移植治疗脂溢性秃发的疗效观察

目的 探讨应用高密度显微外科毛发移植技术,综合移植多种微小型毛胚,治疗脂溢性秃发的临床效果.方法 切取患者头发生长浓密的枕、颞部头皮作为毛发移植供体,5倍专用手术显微镜下分离毛囊,制成多种微小移植毛胚,以三棱针、微型刀片和卵圆形打孔器在受区打孔,用显微外科移植镊,由前向后顺序将移植毛胚植入受区孔隙,术后定期随访.结果 32例脂溢性秃发,移植毛发的平均成活率为90%,Ⅰ期手术后患者满意度为81%,6例不满意患者行Ⅱ期手术后均达到了满意的治疗效果.随访12～24个月,毛发生长自然、密集,发质良好无脱落.结论 应用高密度显微毛发移植技术,综合移植多种微小型毛胚,具有手术时间短、植发密度高、覆盖效果好等优点,大部分患者Ⅰ期手术后即可获得满意的治疗效果.     

高密度自体毛发移植治疗脂溢性秃发的疗效观察

目的 探讨应用高密度显微外科毛发移植技术,综合移植多种微小型毛胚,治疗脂溢性秃发的临床效果.方法 切取患者头发生长浓密的枕、颞部头皮作为毛发移植供体,5倍专用手术显微镜下分离毛囊,制成多种微小移植毛胚,以三棱针、微型刀片和卵圆形打孔器在受区打孔,用显微外科移植镊,由前向后顺序将移植毛胚植入受区孔隙,术后定期随访.结果 32例脂溢性秃发,移植毛发的平均成活率为90%,Ⅰ期手术后患者满意度为81%,6例不满意患者行Ⅱ期手术后均达到了满意的治疗效果.随访12～24个月,毛发生长自然、密集,发质良好无脱落.结论 应用高密度显微毛发移植技术,综合移植多种微小型毛胚,具有手术时间短、植发密度高、覆盖效果好等优点,大部分患者Ⅰ期手术后即可获得满意的治疗效果.     

The scalp as a favorable donor site for limited-sized split-thickness skin grafts in comparison to the thigh donor site

We compared the split-thickness skin graft donor sites of hair bearing scalp (n=86) and thigh (n=27) in 113 patients, predominantly adults over a 6-month period. Donor site morbidity (pain, epithelialization, scars) was evaluated, including intensity and duration of pain, number of dressing changes, and duration of epithelialization of the wound. Graft thickness and quality was identical in the two groups. Patients with grafts from the scalp had fewer complaints than those with grafts from the thigh; they also had faster reepithelialization. Costs for staff and material related to the frequency and duration of dressing changes were significantly lower in patients with scalp grafts. The limited size of these grafts must be considered. The scalp as a donor site has the advantage of lower donor site morbidity with minimal pain and fast epithelialization. There was no scarring or alopecia in any of the patients.     

The scalp as a donor site: revisited

The scalp cannot be used as skin graft donor site with impunity. A review of 2,620 charts identified 194 pediatric patients whose scalps served as donor sites for split-thickness skin grafts for the treatment of acute burns. The overall incidence of alopecia was 32%. However, the incidence of alopecia in unburned scalps was 13%. The occurrence of alopecia in this group was associated with larger burn area requiring more frequent use of the scalp and shorter intervals between graft harvests (p less than 0.05). Among this group of patients (n = 15), nine had mild spotty alopecia, four had surgically correctable alopecia, and two had global patchy alopecia not amenable to surgical correction. In the patients with concomitant burns to their scalps, the incidence of alopecia was 61%. Whether the burn or the graft harvest caused alopecia could not be established. Meticulous donor site care is mandatory in this latter group when the scalp donor site is indicated.     

Bold to do — bald to be? Outcomes decades after harvesting the scalp in burned children

BackgroundThe scalp is the only hidden donor site for split thickness skin grafts. Nevertheless, it is underappreciated due to fear of iatrogenic scarring alopecia. Long-term data showing whether androgenetic hair loss can reveal previously hidden scarring alopecia is unavailable. We aimed to evaluate results and patient satisfaction up to 30 years after skin harvest from the scalp.MethodsBurn patients, hospitalized between 1977 and 1987 at the University Children’s Hospital Zurich with scalp skin harvest and currently over 30 years old, were studied. Medical records and patient satisfaction were analyzed, and a clinical scalp examination was performed.ResultsThirty-two patients (18 males, 14 females) with a current age of 34.13 ± 3.42 years participated. Mean follow-up time was 27.09 ± 3.04 years. Fifty-four scalp harvests were performed with 1.69 ± 0.96 sequential harvests. Hair growth was considered normal in 97% patients. Androgenetic alopecia (AGA) type Norwood II–VI was seen in 11 patients. Scalp examination revealed 11 unknown likely harvest-related alopecias with a mean size of 0.7 cm².ConclusionsLong-term morbidity of scalp skin harvest and the risk of clinically significant alopecia is very low while patient satisfaction is high. AGA is unlikely to reveal harvest damage previously hidden by regrown hair.     

Use of body and beard donor hair in surgical treatment of androgenic alopecia

Objectives:

Follicular unit transplant is a widely used surgical treatment for androgenic alopecia. However, for patients with extensive hair loss (Norwood 5 and above), scalp donor hair are not sufficient to cover all areas of baldness. This study aims to assess suitability of beard and body donor hair when transplanted to the scalp.

Materials and Methods:

In 35 male patients having varying degrees of androgenic alopecia, body and beard donor hair were extracted by follicular unit extraction method (under local anesthesia). They were transplanted in different locations of the scalp. Follow-up was carried out at various intervals (6 months to 2 years). The hairs were observed for colour, curl and calibre.

Results:

In all the patients, there was no change in the colour, curl or calibre of the transplanted body/beard hair. They maintained the same characteristics as in their original location.

Conclusion:

Body and beard hair can be used as additional donor resource for treating androgenic alopecia. These hairs, however, do not change their colour, curl, and shaft diameter (calibre). Thus, proper planning is a must when using the different types of donor hair for transplanting.KEY WORDS: Androgenic alopecia, follicular unit extraction, body donor hair     

Advancement in scalp grafts

Hair transplantation has become the most frequent operation performed on male patients because the results are very gratifying. We have been using the square scalp grafts for more than 10 years. They are an important technical advancement over the round punch grafts because they have 25% more hair than round grafts with the same diameter. The donor site is sutured and leaves only a lineal scar. In this way, grafts can be taken from the same place several times. The grafts are manipulated under magnification to minimize damage. The operation is performed under local anesthesia on an outpatient basis.     

Chest hair micrografts display extended growth in scalp tissue: a case report.

Conventional follicle harvesting techniques for hair transplantation are limited by the available scalp donor hair. The development of an innovative technique of microsurgical single follicular unit extraction has made it possible to exploit body hair grafts for scalp transplantation. This case study reports on 18 months of follow-up on a patient with extensive scalp scarring who underwent a transplantation procedure using donor chest hair. The photographically documented results show a change in the length of the chest hair measuring an average of 4 cm at transplant to 15 cm by 18 months post-transplant. The transplanted chest grafts provided an excellent cosmetic result for hair replacement.