title: Hair follicle-containing punch grafts accelerate chronic ulcer healing: A randomized controlled trial.
abstract: BACKGROUND
  A prominent role of hair follicle-derived cells in epidermal wound closure is now well established but clinical translation of basic research findings is scarce. Although skin punch grafts have been used as a therapeutic intervention to improve healing of chronic leg ulcers, they are normally harvested from nonhairy areas, thus not taking advantage of the reported role of the hair follicle as a wound-healing promoter.
  
  
  OBJECTIVE
  We sought to substantiate the role of hair follicles in venous leg ulcer healing by transplanting hair follicle-containing versus nonhairy punch grafts.
  
  
  METHODS
  This was a randomized controlled trial with intraindividual comparison of hair follicle scalp grafts and nonhairy skin grafts transplanted in parallel into 2 halves of the same ulcer.
  
  
  RESULTS
  Ulcer healing measured as the average percentage reduction 18 weeks postintervention was significantly increased (P = .002) in the hair follicle group with a 75.15% (SD 23.03) ulcer area reduction compared with 33.07% (SD 46.17) in the control group (nonhairy grafts).
  
  
  CONCLUSIONS
  Sample size was small (n = 12).
  
  
  CONCLUSIONS
  Autologous transplantation of terminal hair follicles by scalp punch grafts induces better healing than punch grafts harvested from nonhairy areas. Hair punch grafting is a minimally invasive surgical procedure that appears to be effective as a therapeutic tool for chronic venous leg ulcers.
authors.affiliation: Department of Dermatology, General Hospital of Villarrobledo, Albacete, Spain.
authors.forename: María-Luisa
authors.initials: ML
authors.lastname: Martínez
authors.affiliation: Department of Dermatology, Hospital General Universitario de Albacete and Universidad de Castilla La Mancha, Albacete, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Escario
authors.affiliation: Department of Pathology, Hospital General Universitario Reina Sofía de Murcia and Universidad de Murcia, Murcia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Poblet
authors.affiliation: Department of Ingeniería Cartográfica, Geodesia y Fotogrametría, Universidad Politécnica de Valencia, Valencia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Sánchez
authors.affiliation: Department of Ingeniería Cartográfica, Geodesia y Fotogrametría, Universidad Politécnica de Valencia, Valencia, Spain.
authors.forename: Fernando-Francisco
authors.initials: FF
authors.lastname: Buchón
authors.affiliation: Instituto Biodonostia, Hospital Universitario Donostia, San Sebastian, Spain.
authors.forename: Ander
authors.initials: A
authors.lastname: Izeta
authors.affiliation: Mediteknia Dermatology Clinic, Medical Pathology Group, University of Las Palmas de Gran Canaria, Gran Canaria, Spain. Electronic address: fjimenez@mediteknia.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Jimenez
mesh_terms: D000005:Abdomen; D000368:Aged; D019070:Cell Lineage; D002908:Chronic Disease; D005260:Female; D006097:Granulation Tissue / Q000502:physiology; D018859:Hair Follicle / Q000502:physiology / Q000637:transplantation*; D006801:Humans; D007871:Leg Ulcer / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D059630:Mesenchymal Stem Cells / Q000502:physiology; D058628:Myofibroblasts / Q000502:physiology; D012535:Scalp; D016038:Skin Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
keywords: follicular unit; hair follicle stem cells; hair transplantation; punch grafting; skin grafting; venous leg ulcer; wound healing