RU2691338C1 - Method of autologous transplantation - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to plastic surgery and trichology. There are used: micropunch fixed in a holder, an implant with a needle and plasma enriched with thrombocytes. Method includes the following steps: 1. Follicles are taken from the skin of the patient's donor area with said micropunch by puncturing and immersing it substantially at depth of follicle along the direction of hair growth, temporarily placing them into a nutrient medium. 2. Follicles withdrawn at the previous stage are placed in the skin of the patient's recipient area by means of the above implant, for this purpose, it is immersed into the skin of the patient's recipient area at the required angle to a depth substantially corresponding to the length of the follicle. Number of follicles transplanted at stages 1 and 2 is selected so that the time interval between the beginning of stage 1 and the end of stage 2 is at most 60 minutes.EFFECT: method enables effective correction of complete or partial baldness, improves engraftment of grafts when eliminating or reducing differences of transplanted hair from natural hair, increases hair density in the recipient zone.13 cl, 1 ex, 6 dwg

Description

TECHNICAL FIELD TO WHICH INVENTION RELATES.

The invention relates to the field of medicine, in particular, in plastic surgery and can be used for the correction of complete or partial baldness.

BACKGROUND

There is a method of hair transplantation in which a strip of skin with hair is cut out with a scalpel in the donor area (usually in the occipital region) of the scalp. The donor wound is sutured, and the cut strip of skin is cut on the part of smaller skin with hair - grafts. Cuts are formed in the recipient zone (alopecia zone), and these grafts are inserted into them with tweezers (see O'Tar T. Norwood, "Hair Transplant Surgery". // Charles C. Thomas, Springfield, Illinois, USA, 1984; Kenneth A. Buchwach et al. "Contemporary Hair Transplant Surgery" // Thieme Verlagsgruppe, 1997).

Cuts in the balding area are bleeding, which leads to significant blood loss and pushing grafts out of the wound when applying tweezers. To reduce this effect, titanium obturators are used. Source: Abstract “Method of hair transplantation of autotransplants” dated August 27, 2003.

However, even the use of obturators does not eliminate all the disadvantages of this method.

First, after healing, a large area and a well-marked postoperative scar of 10 ÷ 25 cm in length is formed on the back of the head.

Secondly, the stage of grafts separation from the obtained skin strip takes a long time, as a rule, 2-3 hours or more. All this time, implants are outside the body of patients, which reduces their viability and, as a consequence, the probability of successful engraftment.

Thirdly, when cutting grafts from a strip of skin, cutting tools are used, which leads to additional traumatization and / or loss of viable hair follicles.

Fourthly, the use of cuts in the application of grafts in the area of baldness leads to deep traumatization of the skin, which results in the appearance of a defect in the form of "orange bark", that is, the formation of visible cicatricial contraction at the site of application, which is not only a serious cosmetic problem but also causes inconvenience when using a comb for hair styling.

Fifth, incisions in the balding area cause bleeding, and titanium obturators, designed to reduce it, widen the wound, increasing the wound surface and overly dry the hole, resulting in a decrease in the survival rate of the hair follicles.

Sixth, the impossibility of precise fixation of the implant in the incision relative to the skin surface, characteristic of this method, leads to undesirable changes in the angle and direction of hair growth, and, ultimately, to the so-called. “Puppet effect” of transplanted hair growth.

Seventh, the known method as a whole is characterized both by the considerable length of the procedure and the complexity of the hardware design, since requires the use of expensive disposable medical products - obturators.

DISCLOSURE OF INVENTION

The present invention is the creation of a device with a combination of the following qualities:

1) reduce or eliminate the effect of orange peel;

2) reduction or elimination of the “puppet effect” of hair growth;

3) reducing the time of grafts outside the body and increase their survival rate;

4) the possibility of achieving a higher density of hair production than when using cuts and obturators (due to the insignificant needle diameter of the implanter and the absence of the pushing effect).

The purpose of this invention is to improve the above-described method of hair transplantation, increase the aesthetic effect of transplantation, reduce the time the transplants are outside the patient's body, decrease after procedural complications, better hair survival.

The technical result provided by the use of the invention is to improve the survival rate of grafts while eliminating or reducing the visually distinguishable differences between transplanted hair from natural hair, the possibility of increasing the thickness of hair in the recipient area.

The above problem is solved due to the fact that in the proposed method of autotransplantation of hair, use:

a) micropunch fixed in the holder,

b) an implanter with a needle,

c) plasma enriched with platelets,

characterized in that it includes the following stages:

1) remove the follicles from the skin of the donor area of the patient with the aforementioned micropunch by puncture and immersing it essentially to the depth of the follicle in the direction of hair growth, temporarily placing them in a nutrient medium,

2) place the follicles removed at the previous stage into the skin of the patient's recipient zone by means of the implanter, for which they are immersed in the skin of the patient's recipient zone at a desired angle to a depth essentially corresponding to the follicle length; wherein

the number of follicles transplanted in stages 1 and 2 is chosen so that the time interval between the start of stage 1 and the end of stage 2 is at most 60 minutes.

Further, the aforementioned method, described in the most general categories, is developed on the example of some particularly preferred forms of implementation that provide additional advantages.

The aforementioned platelet-rich plasma, in one of the particular forms of the above method, is an auto-plasma.

The aforementioned micro-punch — in one of the particular forms of the above-mentioned method — is a titanium tube 0.5–0.8 mm thick.

The above-mentioned micro-punch and / or the holder, in one of the particular forms of the above-mentioned method, is made with the possibility of controlling the depth of the micro-pouch.

In the aforementioned method, in one of the particular forms of its implementation, in which the size of the above-mentioned follicle of the patient is preliminarily measured and the immersion depth of the above-mentioned micropanch is limited to substantially the depth of the follicle.

In the above method - in one of the particular forms of its implementation - the immersion depth of the above-mentioned micropanch is 1.5 ÷ 2.0 mm.

In the above method - in one of the particular forms of its implementation - the above mentioned nutrient medium is a mixture of the above plasma and saline solution in a ratio of approximately 1: 5 at a temperature of approximately 4 ° C.

In the aforementioned method, in one of the particular forms of its implementation, between the above stages 1 and 2, the above-mentioned plasma is subcutaneously injected into the recipient zone with microinjections, essentially evenly over its entire area.

In the above method - in one of the particular forms of its implementation - the total volume of the above-mentioned plasma, which is introduced into the recipient zone, is approximately 2.0 ml.

In the aforementioned method — in one of the particular forms of its implementation — after the aforementioned stage 1, the above-mentioned plasma is injected subcutaneously into the donor area with a microscopic injection of the above-mentioned plasma, essentially evenly throughout its area.

In the above method - in one of the particular forms of its implementation - the total volume of the above-mentioned plasma, which is introduced into the donor area, is approximately 2.0 ml.

In the aforementioned method, in one of the particular forms of its implementation, the needle thickness of the aforementioned implanter is approximately 0.6–0.9 mm.

In the aforementioned method, in one of the particular forms of its implementation, the depth of immersion of the needle of the aforementioned implant is fixed by a regulator so that it essentially corresponds to the length of the hair follicle.

In the aforementioned method, in one of the particular forms of its implementation, stages 1 and 2 are repeated until the transplantation is completed over the entire area of the recipient zone.

In the above method - in one of the private forms of its implementation - the duration of the above stages 1 and 2 is 20 ÷ 30 minutes.

In the above method - in one of the private forms of its implementation - the number of follicles transplanted during stage 1 and 2 is 200 ÷ 300.

In the above method - in one of the particular forms of its implementation - the above stages 1 and 2 are carried out in parallel for different parts of the donor and recipient zones.

In the aforementioned method - in one of the particular forms of its implementation - the aforementioned stages 1 and 2 in one donor and / or recipient zone are carried out by means of several micro-pans and / or implanters simultaneously.

In the aforementioned method - in one of the particular forms of its implementation - after the completion of transplantation, the donor zone is treated with fuzycort ointment or 3% tetracycline ointment.

It is necessary to understand that in the present text the invention is characterized only by such signs that are sufficient to solve the task, implement the purpose and achieve the chosen technical result; special mention of all means and methods, without exception, is not required if specialists need to know what the means and methods necessary for the implementation of the claimed invention are, and without them the main purpose is not realized; Moreover, it is not necessary to limit the generalized features to any specific options, if they are to be known to specialists and (or) can be selected according to known rules.

The claimed method is illustrated by figures 1-3 on the example of private and specific variants of the embodiment.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 schematically shows a micro-punch in a holder. A - Holder (holder) with inserted punch. B - Punch (titanium tube 0.8 mm in diameter) enlarged.

FIG. 2 schematically depicts the sequence of actions in the extraction of follicles.

FIG. 3 depicts an implant.

FIG. 4 shows the position of the graft in the needle of the implant.

FIG. 5 schematically depicts the sequence of actions during the implantation of follicles by the implanter.

The picture on the left and right shows the patient before and 12 months after hair transplantation, respectively.

In the figures, the following notation:

11 - the handle;

12 - regulator of the depth of immersion of punch in the skin

13 - plug-in fixed hole for punch;

14 - punch;

21 - Punch movement in the direction and angle of hair growth in the donor area;

22 - follicle is ready for extraction;

23 - follicle extraction with tweezers;

24 - placing the seized follicles in a Petri dish with nutrient solution;

25 - extraction of the next follicle with the obligatory deviations from the previous place of withdrawal to preserve the donor area;

31 - external piston;

32 - housing;

33 - regulator of the depth of immersion of the needle of the implanter into the skin;

34 - the internal piston;

35 - needle;

36 - needle incision;

41 - the internal piston;

42 - needle;

43 - needle incision;

44 - follicle;

51 - insertion of the needle of the implant into the skin to the depth of the graft;

52 - pushing a graft implanter into the skin by a piston;

53 — removing the implant needle from the skin;

54 - a transplant in the skin.

IMPLEMENTATION OF THE INVENTION

Blood sampling.

Immediately before the procedure, venous blood is taken from the patient's cubital vein in the amount of 20 ml, followed by the preparation of platelet-rich plasma.

According to the method of preparing plasma for trichological purposes (proposed by HAIR FORUM, No. 4, International Society of Hair Restoration Surgery, 2013), blood in a test tube is placed in a vibrating machine with an Eva-20 centrifuge for 30 minutes at 30 m / s. The resulting blood clot is removed. The remaining plasma is scrolled at 30 rpm m / s, another 5 minutes, seeking enrichment of plasma with platelets.

Follicle withdrawal.

The removal of the follicle is made manually by means of a titanium tube (micropunch) 0.5 ÷ 0.8 mm thick, fixed in a holder - holder (Fig. 1).

The graft is removed by puncture and immersion of the tool to the depth of the follicle to 1.5 ÷ 2.0 mm in the direction of hair growth (Fig. 2).

The resulting graft does not require separation into parts, because is microtransplant and contains 1-2-3 hair follicles.

The graft is placed in a Petri dish with autoplasma and saline in a ratio of 1: 5 at 4 ° C.

Thus, 200 ÷ 300 transplants are removed, which takes approximately 20 minutes. The total time of the graft in the Petri dish does not exceed 20 ÷ 30 minutes (Fig. 2).

After collecting the grafts in the donor area, a multitude of microrani with a diameter of 0.5–0.8 mm is formed, which heal in 2–3 days.

To improve the healing of the wound surface and restore the donor area, plasma is injected into it in a total volume of approximately 2 ml by subcutaneous injections.

Preparation of the recipient area

The recipient zone is prepared by subcutaneous plasma injection over the entire area.

Graft application

The grafts are placed in the skin of the recipient zone by means of an implanter.

As shown in FIG. 3, the implanter is a syringe, at the end of which there is a needle cut with a diameter of 0.6 ÷ 0.9 mm cut on the upper side. Inside the needle is a micropiston, which is connected to the piston of the syringe. Pressing the plunger of the syringe causes the micropowder to move inward, which, in turn, pushes the hair graft tucked into the needle (1-2-3 hair follicles) into the skin.

The depth of immersion of the follicle is chosen exactly corresponding to the length of the patient's hair follicle, which is measured under a microscope before preparing the implanter to work.

After that, the required immersion depth of the needle of the implanter is fixed with a regulator located in the lower part of the implant, as shown in FIG. 3

The implanted graft consisting of a 1-2-3 follicle is filled into the implanter (Fig. 4).

Then, without any preliminary cuts or punctures, in one motion, piercing the skin to a predetermined depth (up to 2.0 mm) and setting the needle in the right direction, the follicle is placed in the resulting channel at a natural angle of inclination, as shown in FIG. five.

Cycle: removal of a batch of transplants from the donor zone and their application to the recipient zone is carried out several times until the required amount is removed.

Because the diameter of the implant needle and the punch are the same; the graft is precisely fixed in a given direction of hair growth. Plasma, which has soaked the follicle in the Petri dish, glues the follicle to the walls of the channel, which eliminates the effect of pushing the graft.

The use of an implanter in the formulation not only eliminates the effect of pushing out and reduces the time of hair transplantation, but also contributes to a better engraftment of the hair follicles, since without significant delay from the time of extraction, they receive adequate blood supply.

In addition, the small diameter of the needle of the implanter and the absence of the ejection effect allows to achieve a higher density of hair production than when using cuts and obturators.

APPROVATION

With this method of hair transplantation produced more than 2.0 thousand transplants.

Below, as an illustration, presents the most typical example.

Example 1

Patient O., 46 years old, diagnosed with “androgenic alopecia FOR Norwood degrees” (photo, left).

The patient was shown to transplant 3.3 thousand grafts in zone A (frontal zone) with the classic 1st hairline 7-8-9 cm from the eyebrows and with a density of 80 hairs / 1 cm ² . The number of transplants required for transplantation was calculated using a trichoscope and the Trichosines software package; Geometric formulas were used to calculate the transplant area.

The patient wanted to raise the 1st hairline by 1 cm, so 2.212 thousand grafts were actually transplanted to zone A, which resulted in 9 cycles in batches of 200 ÷ 300 follicular hair joints. The 1st line was made according to the calculations of 8-9-10 cm from the eyebrows with care deep into, to connect with the existing hairline before the transplant.

Before the transplantation procedure begins, 20 ml of blood is taken from the patient and about 10 ml of autoplasma is prepared from it in a centrifuge.

Under a magnifying glass, 2.12 thousand hair follicles, representing the 1st, 2nd, or 3rd follicular hair pool, are extracted with a microprong from the donor nape of the patient's area with a microprong of 0.8 mm.

Each seized miniparticle (10 ÷ 15 grafts) is measured and counted under a microscope. Patient's follicle length was 1.5 mm.

Place the removed grafts in a Petri dish with saline and autoplasma of the patient.

Expose the immersion depth of all implanters to no more than 1.5 mm.

Immediately after the removal of the 1st cycle of transplants, plasma is injected subcutaneously into the patient over the entire area of the recipient zone with 0.2 ml microdose.

After the introduction of the plasma, transplants of the 1st cycle are delivered in the amount of 220 transplants by means of an implanter with a needle diameter of 0.9 mm. For this use 6 implanters. When setting, no preliminary cuts or punctures are made; the implant needle is inserted at a natural angle of hair growth to a depth of 1.5 mm.

After staging, they return to the donor area of the patient to retrieve the next group of follicular associations that make up the grafts of the 2nd seizure cycle with their subsequent setting.

Since the entire plasma was introduced immediately after the withdrawal of the follicular associations of the 1st cycle, the cycle of the remaining batches was only 2 stages - withdrawal-staging.

After complete removal of the required number of grafts, futsicort ointment or tetracycline ointment of 3% is applied to the occipital zone.

The final healing of the microlank takes 3–5 days.

Examination of the patient on the 5th day after the procedure showed the absence of post-traumatic soft tissue edema, the healing of micro-cells both in the donor zone and in the recipient zone. There are no complaints.

An interim assessment of hair growth and survival rate was carried out after 4 months (when the patient should take root at least 30–40% of the transplanted follicle). The assessment was made with the help of a trichoscope and the Trichosines software package. Survival rate was 38% of the transplanted hair. Visually, traces of intervention in the donor zone and in the recipient zone are absent. Hair grows at a natural angle of inclination. No noticeable defects in the form of "orange peel" or "puppet effect" of hair growth were found. There are no complaints, the patient is satisfied with the appearance and hair growth.

The final assessment of the survival rate and hair growth was carried out after 12 months by means of a trichoscope and the Trichosines software package. By this time, the patient had taken root and grew 96.5% of the transplanted hair follicles. The density of transplanted hair was 76 ÷ 78 hairs per 1 square meter. cm.

Claims (21)

1. The way autotransplantation of hair, in which they use: a) micropunch fixed in the holder, b) an implanter with a needle, c) plasma enriched with platelets, characterized in that it includes the following stages: 1) remove the follicles from the skin of the donor area of the patient with the aforementioned micropanch by puncture and immersing it essentially to the depth of the follicle in the direction of hair growth, temporarily placing them in a nutrient medium, in particular autoplasma with a saline solution in a ratio of 1: 5 temperature 4 ° C. 2) place the follicles removed at the previous stage into the skin of the patient's recipient zone by means of the implanter, for which they are immersed in the skin of the patient's recipient zone at a desired angle to a depth essentially corresponding to the follicle length; wherein the number of follicles transplanted in stages 1 and 2 is chosen so that the time interval between the start of stage 1 and the end of stage 2 is at most 60 minutes; 3) plasma enriched with platelets is injected subcutaneously into the donor area. 2. The method according to p. 1, characterized in that in it the above-mentioned plasma, enriched with platelets, is an autoplasma. 3. The method according to claim 1, characterized in that in it the above-mentioned micropanch and / or holder is configured to control the depth of immersion of the micropanch. 4. The method according to p. 3, characterized in that it measures the size of the above-mentioned patient's follicle in advance and establishes a limitation for the immersion depth of the above-mentioned micropanch, essentially corresponding to the depth of the follicle. 5. The method according to claim 1, characterized in that between the above-mentioned stages 1 and 2, the above-mentioned plasma is subcutaneously injected into the recipient zone with microinjections essentially evenly throughout its area. 6. The method according to claim 5, characterized in that in it the total volume of the above-mentioned plasma, which is injected into the recipient zone, is approximately 2.0 ml. 7. The method according to claim 1, characterized in that after the above-mentioned stage 1, the above-mentioned plasma is injected subcutaneously into the donor area with microinjections, essentially evenly throughout its area. 8. The method according to p. 7, characterized in that in it the total volume of the above-mentioned plasma, which is injected into the donor zone, is approximately 2.0 ml. 9. The method according to claim 1, characterized in that in it the depth of immersion of the needle of the above-mentioned implanter is fixed by the regulator so that it essentially corresponds to the length of the hair follicle. 10. The method according to claim 1, characterized in that it repeats stages 1 and 2 until the completion of transplantation over the entire area of the recipient zone. 11. The method according to claim 1, characterized in that in it the aforementioned stages 1 and 2 are carried out in parallel for different parts of the donor and recipient zones. 12. The method according to claim 1, characterized in that in it the aforementioned stages 1 and 2 in one donor and / or recipient zone are carried out by means of several micro-pans and / or implanters simultaneously. 13. The method according to claim 1, characterized in that after the completion of transplantation, the donor zone is treated with futsicort ointment or tetracycline ointment 3%.

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