title: A pilot clinical study of hair grafting in chronic leg ulcers.
abstract: Epidermal sheets spread centrifugally postinjury from the hair follicle infundibulum to reepithelialize the wound bed. Healing progresses faster in skin areas rich in terminal hair follicles. These observations are consistent with the role of the hair follicle as a major reservoir for progenitor cells. To evaluate the feasibility and potential healing capacity of autologous scalp follicular grafts transplanted into the wound bed of chronic leg ulcers, 10 patients with ulcers of an average 36.8 cm(2)  size and a 10.5-year duration were included in this pilot study. Within each ulcer we randomly assigned a 2 × 2 cm "experimental" square to receive 20 hair grafts and a nongrafted "control" square of equal size. The procedure seemed to be safe, although major unrelated complications occurred in two patients. At the 18-week end point, we observed a 27.1% ulcer area reduction in the experimental square as compared with 6.5% in the control square (p = 0.046) with a maximum 33.5% vs. 9.7% reduction at week 4 (p = 0.007). Histological analyses showed enhanced epithelialization, neovascularization, and dermal reorganization. We conclude that terminal hair follicle grafting into wound beds is feasible in an outpatient setting and represents a promising therapeutic alternative for nonhealing chronic leg ulcers.
authors.affiliation: Clínica Dr. Jiménez Acosta, Las Palmas de Gran Canaria, Spain. fjimenez@clinicadelpelo.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Jiménez
authors.forename: Carmen
authors.initials: C
authors.lastname: Garde
authors.forename: Enrique
authors.initials: E
authors.lastname: Poblet
authors.forename: Begoña
authors.initials: B
authors.lastname: Jimeno
authors.forename: Jesús
authors.initials: J
authors.lastname: Ortiz
authors.forename: María L
authors.initials: ML
authors.lastname: Martínez
authors.forename: Araika
authors.initials: A
authors.lastname: Gutiérrez-Rivera
authors.forename: Virginia
authors.initials: V
authors.lastname: Pérez-López
authors.forename: Usue
authors.initials: U
authors.lastname: Etxaniz
authors.forename: Corina
authors.initials: C
authors.lastname: Naveda
authors.forename: José L
authors.initials: JL
authors.lastname: Higuera
authors.forename: Nerea
authors.initials: N
authors.lastname: Egüés
authors.forename: Eduardo
authors.initials: E
authors.lastname: Escario
authors.forename: Ander
authors.initials: A
authors.lastname: Izeta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D000078404:Epidermal Cells; D004817:Epidermis / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D018859:Hair Follicle / Q000166:cytology / Q000637:transplantation*; D006801:Humans; D007871:Leg Ulcer / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D062326:Re-Epithelialization; D033581:Stem Cell Transplantation; D013234:Stem Cells; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing