Using Feily's method prevented scalp necrosis in three patients incline to the scalp recipient necrosis; what is new in prevention of scalp necrosis?

Abstract

Serious complications arising from surgical hair restoration are relatively uncommon following well-performed and well-planned surgery by skillful surgical techniques, good communication, and postoperative follow-up. Surgical complications often categorized as those which occur in the donor site and the recipient site. In this paper among recipient area complication we focused on recipient area necrosis that arises when an increased number of recipient grafts are utilized and de-vascularization of the scalp occurs as a result of the large wound area due to the dense packing splitting of recipient skin. Recently, Feily et al. explained an interesting method to prevent development of recipient area necrosis following a hair transplant procedure. Herein we reported three cases of dense hair transplantation using the Feilys method that after slitting they troubled by unusual long lasting dark areas on the scalp and they need more than 24 hr's patience for prevention of scalp necrosis.

Pseudo-dense hair transplantation: Strategy of “less inside, more outside” and central bulking with curled chest hairs as treatment for scalp scars

“…Follicular transplantation into regions of scalp scars is difficult. [ 1 2 ] Several reports document the underlying importance of improved local blood flow via tissue debridement or hyperbaric oxygen therapy, before performing dense hair transplantation. [ 3 ] In a previous study, we described an “ischemia timeline,” toward aiding clinicians to avoid scalp necrosis.…”

“…An important form of cicatricial alopecia is that seen in the post-radiotherapeutic of patients with scalp, skull, or brain tumors. Unfortunately, hair transplantation in regions of secondary scarring alopecia (e.g., radiotherapy, burns, and surgery),[ 1 2 3 4 ] is similarly difficult to the transplantation of a scalp scar for similar pathophysiological reasons. Therefore, transplantation of regions of cicatricial alopecias also require careful planning, minding of the ischemia timeline, and innovative procedural techniques.…”

“…Hair transplantation in areas of such scarring is a clinical challenge, mainly because of the low blood flow, which is not able to provide the necessary oxygen and nutrients to implanted hair follicles. [ 1 2 ] To date, follicular transplantation into regions of scalp scars is not yet standardized. Herein we present an innovative strategy for the management of a scalp scar arising from a prior failed hair transplantation procedure, which seems to provide excellent results in terms of clinical results (i.e., cosmesis) and patients’ satisfaction.…”

Recipient site scalp necrosis: A rare postoperative complication of hair transplantation

“…We reviewed the available literature and found that there are no official guidelines about the etiology, progression, and treatment of scalp necrosis. Morbidity is much higher in a previous study than in our clinical work, 2,10 indicating that technical improvement and good perioperative management may help to reduce this complication 11 . Herein, we reviewed cases with scalp necrosis following hair transplantation over the past decade, and focused on the pathogenesis, progression, treatment, and preoperative prevention of scalp necrosis to minimize complications and improve outcomes.…”

Recycling of Previously Transplanted Hair: A Novel Indication for Follicular Unit Extraction

“…Creating a natural and dense hairline is considered one of the greatest surgical challenges [ 3 ] [ 4 ]. Novice surgical skills and subsequent patient dissatisfaction frequently result in consultation for transplant removal; laser ablation is commonly used for removal.…”