a fruit hanging too low to be seen? preventing fue donor ... · ishrs annual meeting 2014 . dr....
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Dr. med. Conradin von
ALBERTINI
Dr. med. Conradin von
ALBERTINI
A Fruit Hanging Too Low to be Seen?
Preventing FUE Donor Damage with ‚Minimal Depth Control‘
Conradin von Albertini, MD, Switzerland
ISHRS Annual Meeting 2014
Dr. med. Conradin von
ALBERTINI
Disclaimer
§ I have no relevant financial relationships or conflicts of interest to declare.
§ No photography please.
ISHRS Kuala Lumpur, October 10, 2014 2
Dr. med. Conradin von
ALBERTINI
Donor complications in Giga FUE
§ FUE = very low risk!
§ But: ‘Giga rat race’ = Shock hair loss & necrosis?
§ Personal relevance: 2000-3000 FUs per day (w/PCID®)
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Source: Harris (2014)
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
Tissue damage in FUE donor sites
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How can we quantify it? A
How can we reduce it? B
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
A – Quantify the damage: Wound surface „Perpendicular punch holes“ (simplification)
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2πrh + πr2 = = cylinder surface
circle area 90°
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
B – Reducing the wound surface: Options
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Less grafts 1
Smaller punch diameter 2
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
4 mm
1.2 mm
Smaller punch diameter: A classic
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- 35 % 16.2 mm2 10.6 mm2
0.8 mm
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
A 3rd option for less donor damage ?
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Less grafts 1
Smaller punch diameter 2
Smaller depth ? 3
ISHRS Kuala Lumpur, October 10, 2014
Dr. med. Conradin von
ALBERTINI
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Source: Cole (2009)
2.3 mm
Minimal depth (e.g. PCID®) ISHRS Kuala Lumpur, October 10, 2014
4 mm
Full depth
Smaller depth : Minimal depth control
Dr. med. Conradin von
ALBERTINI
1.2 mm
4 mm
2.3 mm
Smaller depth
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- 40 %
ISHRS Kuala Lumpur, October 10, 2014
9.8 mm2
16.2 mm2
= Smaller wound surface
Dr. med. Conradin von
ALBERTINI
534 cm2
320 cm2
4.0 mm
2.3 mm
Giga FUE donor wound surface: 4000 FUs
Diameter: 1mm Depth:
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- 40 %
Dr. med. Conradin von
ALBERTINI
Equal above the bulge
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Histology:
ISHRS Kuala Lumpur, October 10, 2014
4.0 mm 2.3 mm
Dr. med. Conradin von
ALBERTINI
Less surface below the bulge
13 ISHRS Kuala Lumpur, October 10, 2014
Histology: 4.0 mm 2.3 mm
Dr. med. Conradin von
ALBERTINI
Intact “shiny layer”
14 ISHRS Kuala Lumpur, October 10, 2014
Macroscopic:
Dr. med. Conradin von
ALBERTINI
My conclusions
Do not underestimate the donor damage of Giga FUEs – e.g. limit grafts, wait > 4 months
15 ISHRS Kuala Lumpur, October 10, 2014
Minimal depth control = helps not only to avoid transaction, but may also further reduce the donor wound in FUEs
A
B
Dr. med. Conradin von
ALBERTINI
Dr. med. Conradin von
ALBERTINI
Is the Fruit Hanging Low ?
‚Minimal Depth Control‘ to Prevent FUE Donor Damage
Conradin von Albertini, MD