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Graft assisted donor closure (GAD) for strip & FUSE/fue


#1

Dear forum readers and fellow HT doctors,
I am pleased to inform you of a new addition/method of donor closure after strip FUHT excision.

The step, in simple terms, involves placing grafts into the closed suture wound a few hours after the suturing has been done.

This is something patients used to ask about.

We have performed test sessions in over 50 patients in 2013.

The result has led to less visible scarring (without need of trichophytic closure), better cosmesis and healing.

For this purpose we chose to transplant beard hair into identified area of the strip suture and followed the progress. Beard hair were extracted using the FUSE method.

Beard hair was used as it could be easily identified due to its differing characteristics. Thus, preventing chances of confusion.


However, its a proof of concept. Scalp hair or robust body hair can also be transplanted to achieve the GAD closure


Delayed Graft Assisted Donor closure for FUSE -
We also transplanted FUSE grafts into the donor wounds of scalp FUSE 3 days after the creation of the donor wounds.
Veteran readers may remember the Donor Exchange method, we had done many years ago. The difference is that waiting for 48-72 hours after FUSE/fue wound creation allows the -

  1. Donor hole to contract, and,
  2. Granulation tissue to form.

I hope this helps other doctors and patients alike.

We shall be sharing the detailed methodology and pictures in days to come.

Please let me know if you have any queries.

Regards,
Dr. A


#2

Dr. Arvind, if I understand this correctly this is only for those who want strip surgery?


#3

[quote][postedby]Originally Posted by Blu[/postedby]
Dr. Arvind, if I understand this correctly this is only for those who want strip surgery?[/quote]

Dear Blu,
No the concept is not for strip patients alone.
There are some patients who may prefer to over-harvest the scalp donor for transplant by FUSE/fue and to replenish the scalp donor with beard/robust body hair.


However, and I will leave this for another thread, there is a need to understand that in the art of HT , a uniformity/singularity is more important. But, as I said, lets leave that for a separate thread to avoid confusion.

Regards,
Dr. A


#4

Dr A,

That sounds great - presumably the only downside is that the patient would need to schedule a longer visit to complete the sugery?


#5

Dr. A, your GAD will not be necessary now that other doctors are using Acell and PRP for the donor.


#6

[quote][postedby]Originally Posted by gambler[/postedby]
Dr A,

That sounds great - presumably the only downside is that the patient would need to schedule a longer visit to complete the sugery?[/quote]

Dear Gambler,
For the strip FUHT patient, its done on the same day, so no longer visit required.
For FUSE/fue patients, yes I would advise an additional 3 days to their itinerary.

Regards,
Dr. A


#7

[quote][postedby]Originally Posted by HMorHT[/postedby]
Dr. A, your GAD will not be necessary now that other doctors are using Acell and PRP for the donor.[/quote]

Dear HMorHT,
Having viewed their presentations, in my opinion, such purported treatments are fallacy at best.
Regards,
Dr. A


#8

Dear readers and fellow HT doctors,
The steps we followed for the GAD closure in strip surgery are-

  1. Taking out the strip and closing the suture wound in two layers with 4’ o monofilament suture.

  2. Beard grafts were extracted by FUSE method and transplanted into an identifiable portion of the sutured strip wound towards the end of the surgery on the same day.

Pictures to follow soon.
Regards,
Dr. A


#9

Following are some pictures showing the beard hair growth in scar and a comparison picture