Hair transplant in burn scar alopecia is always remaining the hardest challenge both for the patient and the surgeon. This process consists of more than one stage and often continues for several years. Many recovery procedures are also required after the burning phase. In this treatment procedure, it is difficult to extract grafts and these grafts are not as effective as the grafts that are extracted from the scalp that have no wounds or that are healthy. As these grafts are not effective enough that’s why more than one surgical procedure is needed to gain the desired density. In addition to this, the surgery of different wounded areas is also different and this also indicates the need for more than one surgical procedure. The surgical procedures that are used for the treatment of such wounds are the follicular unit extraction (FUE) technique or the strip follicular unit transplantation (FUT) technique. These two methods are proved to be very effective in the treatment of such types of scarring alopecia and give more clear and refined results.
The thing that makes hair transplant in burn scar alopecia more challenging is the deep wounds that destroy the HFs and make the procedure more difficult. The surgical procedure that is used in this process will depend upon the number of factors i.e., which part is affected and what is the magnitude of the affected area. So, in the consideration of these factors different restoration techniques are used such as HF containing flaps with the widening of tissue or without the widening of tissue, HF containing thickened grafts, serial excision with tissue widening or without tissue widening, FUE, and FUT. As it was illustrated that in the results of these procedures the patient gains a restricted density of HFs so, to get the desired results these procedures have to be performed more than one time and another extra procedure is also performed to decrease the magnitude of bruised area. It aids the surgical procedure in getting more natural results.
Hair transplant in burn scar alopecia is successfully and effectively practiced worldwide. Before starting the procedure, the following points should be considered that wounds on the bruised area should be fully mature i.e. they should be pale, soft, and flat. Because the wounds were of pink color the bleeding can start from the wounds during surgery and the grafts that injected can be evicted because of blood flow and the composition and physiology of the cutaneous layer of the skin become altered and the natural capability of the two held the grafts in place will be finished. Another important point that should be considered is the elasticity of the scalp because if there is not enough flexibility in the skin, there would not be a proper closure of the wound. Another important point that needs to be considered is the vascularity of the mature wound. Because the blood supply in the wound is not appropriated or if it will be diminished it will influence the inserted grafts and more dense insertion of grafts will also affect the blood supply that consequently causes necrosis grafted area and tissue.
Hair transplant in burn scar alopecia used two types of surgical procedures. One is FUT and the other is FUE. In FUT, a strip of skin is excised from the donor area of the patient and this method leaves a surgical bruise of linear scar on the patient’s scalp. It is the more rapid way of harvesting HF grafts in contrast to the FUE technique. In the FUE technique, the site from which HFs are extracted is a small round dotted bruise left instead of a linear shape wound. This technique is considered to be more effective for the treatment of HF loss in the bruised area because in the bruised area the skin is often rigid and less flexible and if FUT is used in this condition only a small, thin strip will be extracted that contains a limited number of HFs. Thus, these surgical procedures recover the small to large bruised areas and restore the natural look.
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