Chinmanat Lekhavat1, Pinyo Rattanaumpawan2, Prapote Asawaworarit3, Kowit Kampirapap1, Prapawan Chawvavanich1, Damkerng Pathomvanich4. 1. Department of Medical Services, Institute of Dermatology, Ministry of Public Health, 420/7 Rajvithi Rd., Phayathai District, Rajthevee, Bangkok, 10400, Thailand. 2. Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok, 10700, Thailand. 3. DHT Clinic, 408/138 Paholyothin Place Bldg., Floor 32, Paholyothin Road, Phayathai, Bangkok, 10400, Thailand. 4. DHT Clinic, 408/138 Paholyothin Place Bldg., Floor 32, Paholyothin Road, Phayathai, Bangkok, 10400, Thailand. path_d@hotmail.com.
Abstract
BACKGROUND: The linear scar and misalignment of hair follicles are disadvantages of the follicular unit transplantation (FUT) or strip technique. The most common misalignment is at the end of the strip. Although most surgeons try to match hair direction to achieve optimal hair alignment, their attempts are often unsuccessful. OBJECTIVES: We aimed to assess strip designs to improve hair alignment during hair transplantation. METHODS: We conducted a retrospective study of 157 patients who underwent hair transplantation with either the commonly used elliptical incision or our novel triangular flag-shaped designed incision on the donor strip tip. Two blind evaluators assessed the outcome of hair alignment using a 5-point visual analog scale. RESULTS: In total, 303 wounds on 157 patients were assessed. Overall, our triangular flag-shaped design (TFD) achieved better hair alignment than the common elliptical design (CED) (p=0.01). Patients with hair direction straight on the upper wound edge and hair direction inward on the lower wound edge showed improved outcomes with TFD, whereas patients with hair direction inward on both upper and lower wound edges showed better outcomes with CED. CONCLUSIONS: The TFD tip of donor strips achieved proper hair alignment for most hair transplant patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
BACKGROUND: The linear scar and misalignment of hair follicles are disadvantages of the follicular unit transplantation (FUT) or strip technique. The most common misalignment is at the end of the strip. Although most surgeons try to match hair direction to achieve optimal hair alignment, their attempts are often unsuccessful. OBJECTIVES: We aimed to assess strip designs to improve hair alignment during hair transplantation. METHODS: We conducted a retrospective study of 157 patients who underwent hair transplantation with either the commonly used elliptical incision or our novel triangular flag-shaped designed incision on the donor strip tip. Two blind evaluators assessed the outcome of hair alignment using a 5-point visual analog scale. RESULTS: In total, 303 wounds on 157 patients were assessed. Overall, our triangular flag-shaped design (TFD) achieved better hair alignment than the common elliptical design (CED) (p=0.01). Patients with hair direction straight on the upper wound edge and hair direction inward on the lower wound edge showed improved outcomes with TFD, whereas patients with hair direction inward on both upper and lower wound edges showed better outcomes with CED. CONCLUSIONS: The TFD tip of donor strips achieved proper hair alignment for most hair transplant patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .