title: Minimizing injury to the donor area in follicular unit extraction (FUE) harvesting.
abstract: BACKGROUND
  Follicular Unit Extraction (FUE) is considered to be a minimally invasive procedure, and the injury to the donor area caused by a sharp punch may result in dermal fibrosis and clinically observed hypopigmentation.
  
  
  OBJECTIVE
  To evaluate with advanced image processing the efficacy of using 0.9% normal saline in minimizing the injury to the donor area in FUE donor harvesting.
  
  
  METHODS
  The term acute extraction (AE) is used to describe the donor harvesting technique, whereby a follicular unit (FU) is removed with a punch that is aligned parallel with the exit angle of the hair follicle. The term vertical extraction (VE) describes the technique where a FU is removed in like manner, but normal saline is injected intradermally prior to harvesting so the punch being perpendicular to the skin. Thirty-five patients were selected for this study to apply both harvesting techniques and then to compare the differences in wound surface size and skin mass removed by the punch.
  
  
  RESULTS
  A significant reduction in the mean values of wound surface and skin mass was recorded in vertical extraction compared to those in acute extraction.
  
  
  CONCLUSIONS
  The injection of normal saline prior to harvesting proved to be very efficient in minimizing skin injury in FUE harvesting.
authors.affiliation: Haarklinikken, Copenhagen, Denmark.|Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Zontos
authors.affiliation: Family Medicine, Western University of Health Science, Pomona, CA, USA.
authors.forename: Ken L
authors.initials: KL
authors.lastname: Williams
authors.affiliation: Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Nikiforidis
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control; D003357:Cosmetic Techniques / Q000009:adverse effects; D018859:Hair Follicle / Q000637:transplantation*; D006801:Humans; D017496:Hypopigmentation / Q000209:etiology / Q000517:prevention & control; D007091:Image Processing, Computer-Assisted; D007271:Injections, Intradermal; D008875:Middle Aged; D010781:Photography; D012965:Sodium Chloride / Q000008:administration & dosage*; D000072836:Surgical Wound / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods*; D060053:Transplant Donor Site / Q000000981:diagnostic imaging / Q000293:injuries*; D055815:Young Adult
chemical_list: D012965:Sodium Chloride
keywords: follicular unit extraction; hair transplant; hypopigmentation; image processing; injury to the donor area; normal saline