RU2757958C1 - Method for hair transplantation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to trichology. The hair in the donor area is shaved to the skin level at least 12 to 24 hours prior to the hair transplantation operation, then the donor area is examined upon expiry of said period of time and the hair with follicles in anagen is detected, then grafts containing hair with follicles in anagen are taken from the donor area. Slit-like microholes for graft transplantation are formed in the recipient area, and the grafts taken from the donor area are implanted in the formed slit-like microholes of the recipient area by means of an implantation agent.

EFFECT: method provides a possibility of increasing the survival rate of the implanted hair while simultaneously reducing the injury rate of the donor area.

4 cl, 2 ex

Description

The invention relates to medicine, namely to plastic surgery for hair transplantation.

Currently, various methods of treatment are widely used, such as: autologous hair transplantation, flap plastics, excision of balding skin, plastics using expander and extenders (scalp reduction), rarely implantation (transplantation) of artificial hair.

Hair transplant is a method of restoring hair on the head of a person, as well as in the areas of the mustache, beard, sideburns, eyebrows, eyelashes by a surgical method. It is used for progressive alopecia of various types, as well as for hiding scars, wounds, burns, and the consequences of unsuccessful plastic surgeries on the face. The world standard for hair implantation is considered to be at least 90%. That is, out of 10 transplanted hairs, at least 9 should take root. At the same time, the density of the transplanted hair should reach 70-80% of the natural one (per 1 sq. Cm in a person it is about 300 hairs).

The history of hair transplant dates back to the 30s of the last century. In 1939, Japanese physician Shoji Okuda published a series of articles titled Clinical and Experimental Hair Transplant. In these articles, he analyzed his hair transplant results in wounded soldiers with extensive burns and head wounds. In 1959, the American surgeon N. Orintreich developed and described the method of punching biopsy of grafts, which became known as punch or plugs methods. For the extraction of grafts, Orientreich used trocars 6-12 mm in diameter. Transplantation of grafts of this size caused large losses of donor material. At first, attempts to reduce the size of grafts did not justify themselves. As a result of transplanting such large grafts (6-12 mm), the effect of a “doll head” or “toothbrush” is created, and the healing process of the donor area often gives a “cobblestone” effect with numerous white scars.

After 30 years, Emmanuel Maritt proposed to transplant hair not with islands of skin, but with the method of single grafts containing a single-hair root. Later, the method of transplanting grafts of this size (0.8-1.0 mm) was called micrografting. With this method, a hair-bearing skin flap is taken from the donor zone (back of the head), which is divided into thousands of tiny grafts: monografts containing 1 follicle and micrografts with 1-3 follicles. The use of small grafts gives a natural look and maximum density of the transplanted hair, however, despite the more than satisfactory results of this method and the many years of research and efforts of transplant surgeons around the world, the problem of scar formation in the donor area remains unresolved.

In 1995-2000, American hair transplantologists Robert Bernstein and William Rossman formulated the concept of follicular unit transplantation. Based on this concept, hair follicles are transplanted as follicular units, i.e. in the same form in which they grow in their natural environment on the scalp. The peculiarity of this method is that the extraction of hair follicles, in particular mono- and microphages, is carried out without skin incision using a special miniature instrument under the control of optical instruments. The author of the method - Dr. W. Rassman called it "Follicular Unit Extraction (FUE)". The absence of scars in the donor and recipient zones significantly improves the cosmetic effect of such autotransplantation, makes it possible to evenly distribute the transplanted hair in the baldness zones, to obtain the most natural result.

The International Society of Hair Restoration Surgery (ISHRS) officially recognizes two methods of hair transplantation - seamless method FUE (Follicular Unit Extraction) and patchwork FUT [(English Follicular Unit Transplantation), also known as STRIP ( English strip - flap, strip) method.

From the prior art (RU 2550428 C2, 05/10/2015) there is a known method of hair transplantation, which consists in the fact that preliminary, using the TrichoSciencePro v 1.1 program, measure the area of the recipient area, the number of follicles required for transplantation, the number of viable and non-viable hair follicles ... Next, a phototrichogram is performed: the hair in the recipient area is dyed with hair dye in a color different from the patient's natural color. After 3-4 days, the grown hairs are counted - these hairs (follicles) are in anagen (viable). With the help of the performed phototrichogram, the doctor can clearly know the number of follicles required for transplantation, as well as calculate the area of the donor area.

The calculation of the area of the donor (hairy) area is also carried out using the TrichoSciencePro v 1.1 program and, accordingly, a phototrichogram is performed to identify the viability of the follicles. In the future, according to the template, the area of the donor area that will be optimal is excised. To increase the viability of follicular grafts, firstly 1/3 of the donor flap is excised. After the phototrichogram is carried out, only follicles with grown hair (in anagen) are removed.

The known method is rather laborious and time-consuming, which increases the duration and cost of preoperative preparation.

A system and methods for planning hair transplantation are also known (see US10143522 B2, 04.12.2018). In this method, the study of the donor zone consists in creating and displaying on a three-dimensional model at least two surface elements with hair, each of these elements containing one or more control points. Control points have corresponding parameters. Using a computer program, one or more suggested areas of follicular units in the first and second hair surface elements are modified or generated. The robotic system is then initiated and calibrated, and the body surface image data is collected and processed by the system computer to identify objects, in particular follicular units, in a donor element, for example, on the human scalp. Based on the images of this element of interest, the image segmentation and screening software identifies and selects the specific follicular units of interest to be retrieved from the scalp.

This method gives low accuracy, because all hair growth data is modeled using software.

Systems and methods for controlling hair loss are known (US 2017019437, 02.02.2017). One of the stages of these systems and methods is to determine the stage of hair growth. Before the hair transplant procedure, the proportion of anagen hair is determined. First, the region of interest is identified. The hair is then cut in this area to a length of about 0.5 mm to 1.0 mm in height, and a first image is acquired, for example, with an imaging system, hair detection, and the first length of each hair of the area that has been trimmed is determined. The first length is determined from the point at which the hair extends from the body surface to the tip (proximal to the body surface).

After a certain period of time, for example, after one to three days, a second image of the hair in the selected area is re-acquired and a new hair length is determined. The first hair length at the first time point is then automatically compared with the second hair length at the second time point. Such a comparison can be done, for example, using an algorithm executed by the processor. Based on the comparison of the second length with the first length, the phase of hair growth in the selected area is classified.

Hair with follicles in anagen has grown by more than 0.25-0.45 mm per day, for example 0.33 mm per day. If the hair has practically not grown, then their follicles are in the telogen. Therefore, if the time interval between the first and second acquired images is 3 days, hairs that have grown by about 1 mm in a 3-day period of time are identified. They are the ones who are in the anagen. This classification can be done automatically.

This stage of preparation for hair transplantation is long, since it takes at least three days to identify the growth phase in which the follicles are located, and, therefore, hair transplantation takes a lot of time (long).

The closest analogue to the claimed invention is a method of hair transplantation by transplanting follicular grafts from the hairy (donor) to the bald part of the head (RU 2171642 C2, 08/10/2001). From the skin of the scalp using the FUE method, grafts are obtained, after which, on the skin of the bald part of the head, in accordance with the shape of the restored hair area (recipient zone) and the required thickness of the hairline, slotted micro-holes (form channels) are formed, into which grafts are transplanted. Grafts containing from 1 to 2 hair follicles are placed on the border of the formed hairline (anterior hairline), and a set of grafts containing from 2 to 4 hair follicles are placed on the remaining area.

This method has a low trauma and a good cosmetic effect, however, there is a possibility of transplanting weakened follicles (located in telogen), which can lead to a decrease in the number of hair growth, loss of donor resource and, ultimately, to a subsequent deterioration of the overall cosmetic effect.

The technical problem to be solved by the invention is to improve the method of hair transplantation, namely, to improve the quality of the donor material and the number of grafts that take root.

The technical result achieved by solving a technical problem is to increase the survival rate of the implanted hair while reducing the trauma of the donor area.

The technical problem is solved, and the technical result is achieved due to the fact that a method of hair transplantation is used, including the stages at which

- shave the hair of the donor area to the skin level at least 12 to 24 hours before the hair transplant operation,

- examine the donor area after the mentioned period of time and identify the hair, the follicles of which are in anagen,

- grafts containing hair, the follicles of which are in anagen, are taken from the donor area,

- form slit-like micro-holes for graft transplantation in the recipient zone;

- grafts selected from the donor area are implanted into the formed slit-like micro-holes of the recipient area by means of an implantation device.

In the particular case of the implementation of the invention, the slot-like micro-holes are formed taking into account the direction and angle of hair growth.

Also, the technical problem is solved, and the technical result is achieved, due to the fact that at the stage of examination of the donor zone, the direction and angle of hair growth are additionally determined, the follicles of which are in anagen.

In the particular case of the implementation of the invention, the direction and angle of hair growth are determined by means of a trichoscope.

Hair removal from the donor area at least 12 to 24 hours prior to the hair transplantation operation allows hair to grow to a length at which it is possible to determine with high accuracy what phase the hair follicle is in (anagen / telogen). Given that the hair grows unevenly during the day, a shorter period may not give sufficient growth to determine the phase in which the follicle is located, and a longer period will allow hair to grow to a length that will interfere with a full collection of follicles.

Implementation of the invention.

Previously, after determining the number of necessary grafts and assessing the skin condition of the donor area, in the absence of contraindications, the donor area is trimmed and the donor area is shaved.

The priority area for the collection of follicular grafts is the occipital region. It contains hair that is resistant to the action of androgens and therefore is not subject to androgenetic alopecia. In the central part of the occipital region, strong and thick hairs are most densely located, then towards the periphery their density and thickness somewhat decrease; the hair of the temporal regions is thinner and thinner.

After at least 12 - 24 hours, the donor area is assessed using a trichoscope and local optics with at least 4x magnification. Hair with follicles in anagen (more active and viable) will rise 0.3 mm above the skin level, hair with follicles in telogen (less active and less viable) will be at the skin level.

Then local anesthesia of the donor area is performed. The collection of follicles from the donor area is carried out using medical optics of 4-6 times magnification and a headlamp. A cylindrical cutting hollow needle (punch-punch) with a diameter of 0.75-0.85 mm is inserted into the skin in the direction of hair growth at an angle, parallel to the hair trunks to avoid hair crossing. Only hair that rises above the skin level by 0.3 mm is taken. Hair that is at the level of the skin is not picked up. The depth of the needle entry corresponds to the follicle length 4.0 - 6.0 mm. The follicular graft is freely removed. The resulting grafts are sorted and laid out on sterile napkins in containers moistened with 0.9% sodium chloride solution, cooled by cooling gel pads located under the containers, which help to increase the graft survival, and stored under optimal conditions until the time of transplantation (in a refrigerated solution at a temperature of 4 ° C).

In the recipient zone, evenly, in accordance with the angle of hair growth and the direction determined by the residual hair in the hair loss zone, silk-like micro-holes are formed due to skin perforation. The number of micro-holes corresponds to the number of removed grafts. The grafts extracted from the donor area are transplanted with microtweezers.

In one procedure, you can remove from 10 to 3500 grafts. At the same time, the donor zone is preserved for subsequent transplants.

After follicle extraction, the donor area is treated with antiseptic solutions. At the same time, microperforations are not sutured, they heal quickly and become invisible after new hair begins to grow. There is no need to apply a permanent bandage. The recovery process and the healing period proceed quickly and with minimal pain.

Grafts take root completely in 95-98% of cases within a week after surgery.

Microperforations in the donor area heal completely within 7 days. Slight painful sensations do occur, but are quickly relieved by taking conventional analgesics. Patients can return to normal work activities as early as 2 days, and 3 days after the transplant, they can wash their hair.

Examples of implementation of the invention.

Example 1. Patient Y., 54 years old, applied to the RTH clinic for androgenetic alopecia 3 tbsp. according to Norwood. A seamless transplant of one's own hair was performed using the claimed method. Follicular grafts were transplanted from the occipital region to the fronto-parietal region: 1700 grafts. Local anesthesia. The transplant result is satisfactory.

Example 2. Patient K., 57 years old, came to the RTH clinic for hair loss in the crown region. Correction of the area of the "cardinal's cap" is performed by the claimed seamless method. Local anesthesia. 1660 grafts were transplanted. The transplant result is satisfactory.

Thus, the inventive method allows you to extract the exact amount of grafts in anagen, thereby increasing the implanted hair survival rate while reducing trauma to the donor area.

Claims (9)

1. A method of hair transplantation, including the stages at which - shave the hair of the donor area to the skin level 12-24 hours before the hair transplant operation, - examine the donor area after the mentioned period of time and identify the hair, the follicles of which are in anagen, - grafts containing hair, the follicles of which are in anagen, are taken from the donor area, - form slit-like micro-holes for graft transplantation in the recipient zone; - grafts selected from the donor area are implanted into the formed slit-like micro-holes of the recipient area by means of an implantation device. 2. The method of claim 1, wherein the micro-slotted holes are formed taking into account the direction and angle of hair growth. 3. The method according to claim 1, wherein at the stage of examining the donor zone, the direction and angle of hair growth, the follicles of which are in anagen, are additionally determined. 4. The method of claim 3, wherein the direction and angle of hair growth is determined by means of a trichoscope.