Expanded flap and hair follicle transplantation for reconstruction of postburn scalp alopecia.
The advent of tissue expansion started a new era of aesthetically reconstructed scalp alopecia by providing a large hair-bearing scalp area with acceptable hair density. However, residual scalp alopecia and wide visible scars still raised aesthetic problems. The hair follicle transplantation carries the possibility of producing a more natural scalp because both the desired hair density and the natural direction of the hair can be reproduced using this procedure. Our study group consisted of 62 patients (41 males and 21 females) with a mean age of 26.3 years. The median age of suffering a burn to the scalp was 3 years. The causes of burn resulting to scalp alopecia were flame (n = 28), scald (n = 18), contact (n = 7), and electrical (n = 9) injuries. The first reconstruction for all patients was the expanded flap coverage. Three patients used 2-stage expanded flaps. Five patients underwent hair follicle transplantation after they had undergone the expanded flap coverage. Expanders (n = 86) were placed in 62 patients with a total of 9 major (9.3%) and 3 minor (3.5%) complications. The overall results after expanded flap reconstruction and hair follicle transplantation were excellent (43 patients, 69.4%), good (18 patients, 29%), and bad (1 patient, 1.6%). Postburn scalp alopecia can be reconstructed by 1-stage or multiple-stage expanded flap procedures. The visible remaining alopecia and marginal scar after the procedure, especially on the anterior hairline of the forehead and the sideburns, can be refined by hair follicle transplantation. This report also suggests the possibility that cicatrical scalp alopecia with intact deep tissue can be restored by hair follicle transplantations using hair transplanter.
Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital Hallym University Medical Center, Gyeonggi-do, Republic of Korea. sjoh@hallym.or.kr
Suk Joon
SJ
Oh
Sung Hoon
SH
Koh
Jong Wook
JW
Lee
Young Chul
YC
Jang
D000038:Abscess / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000505:Alopecia / Q000601:surgery*; D002056:Burns / Q000150:complications* / Q000601:surgery; D002058:Burns, Electric / Q000150:complications / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000601:surgery; D020878:Device Removal; D004954:Esthetics; D005260:Female; D018859:Hair Follicle / Q000637:transplantation*; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019106:Postoperative Hemorrhage / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000293:injuries* / Q000601:surgery; D013524:Surgical Flaps / Q000473:pathology*; D013530:Surgical Wound Infection / Q000209:etiology; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult