Time out of body; A very important aspect

[Swooping]

Just for the record Lorenzo because he does all the implantations himself and has multiple cases going has had grafts stored for up to 6 hours in my observation without much concern. I do not know what solution he uses but patients post spray their donor area post op with plain saline.

 

Thanks good information. 6 hours even in normal saline should be acceptable though. Personally I wouldn't go for higher times than that without better mediums though. But to everyone his own obviously. Do you know what solution & storage method Lorenzo uses? Would be great too know that.

 

In ISHRS conference at San francisco and Malaysia much was talked about these solutions .ultimately it was concluded newer storage solution will help in improving the bit extra graft survival in a successful HTclinic. But graft drying is considered more dangerous even if you use whatever storage solution .As I said earlier with FUE you have the privilege of transplanting the grafts simultaneously after harvesting.

 

As evidenced based studies are missing and concurrent concepts are not confirmed or falsified. any hair transplant surgeon has the freedom to choose the solution that fits best in his experience and office needs including the financial status of his patients.

 

Thanks hairsure, interesting. It is a privilege for FUE that should be used indeed by everyone. I really don't see why there should be high out of time body times with FUE (6 hour+ imo), as you can just split sessions basically indeed.

 

If this privilege is used accordingly then the solution & storage method probably doesn't matter..? Perhaps it does, but it's highly likely that it isn't statistically significant or important in that case. However indeed evidence based studies are missing, so we can only guess!

[KO]

Here is another article from this site:

 

The Best Graft Storage Solutions in Hair Transplantation | Hair Loss Q & A

 

Two years ago I did an extensive research study comparing grafts stored in normal saline for half of the 16 study boxes and grafts stored in HypoThermosol solution with ATP added to it in the other half of the boxes. ATP is a chemical in our bodies that fights apoptosis (cell death) which occurs in the absence of oxygen. We planted grafts in the paired study boxes (one saline, and the other HypoThermosol/ATP) at the following time points: 2 hours, 4 hours, 6 hours, 8 hours, 24 hours, 48 hours, 72 hours, and 96 hours.

 

The findings from this research are basically that for under 8 hours they are similar from a statistical standpoint. This confirmed the results Dr. Bobby Limmer in Texas achieved 19 years ago in his landmark study extending to 48 hours. In our study, for 24 hours and thereafter, there was a huge difference in survival in favor of the HypoThermosol/ATP grafts doing much, much better in survival percentage. Besides the superiority in percentage of grafts that survived, there was also a qualitative difference between the grafts in saline and those in HypoThermosol at 24 hours and beyond. The hairs growing from the HypoThermosol/ATP boxes were much fuller in diameter while the ones in saline were thinner.

 

In our own practice we use Plasma-Lyte solution, which is very close in pH (acidity) to human plasma, to hold all of our grafts. It is certainly more expensive than saline, but not exorbitant. HypoThermosol (especially if ATP were added), on the other hand, is much, much more expensive and, if used routinely in hair transplants, would have a serious impact on the price patients would have to pay for surgical hair restoration. The evidence so far certainly does not support the routine use of such an expensive solution. Perhaps there might be the occasional patient in whom a large number of pluggy grafts are being extracted via follicular unit extraction (FUE) and recycled into the scalp. Such grafts may be more susceptible to cell death and benefit from this type of fancy solution. Dr. Jerry Cooley has also done recent research using HypoThermosol with ATP added, but I don’t think we can even sort out from our research what percentage of the benefit was due to the HypoThermosol versus the contribution from the added ATP.

 

The instances in which follicular unit grafts have to be placed days later are very rare. I have only had one such episode in 22 years, when around 10 years ago a 35 year old developed chest pain and sweating during the procedure right after we had harvested all of the donor hair and had made around 200 small recipient sites. We had him moved immediately by ambulance to the hospital, where he was cleared that night and sent out with a diagnosis of a virus and some hyperventilation. He called me that night and we agreed to meet the next day, at which time we inserted the grafts and finished the procedure. These grafts were out 24 hours and grew fairly well from visual observation. In truth, it’s virtually impossible to distinguish 70% growth from 95% growth. This was proven by Dr. Manny Marritt years ago and published in Dermatologic Surgery Journal.

 

So the bottom line is that the jury is still out on what the perfect solution is. We’ve been using Plasma-Lyte for around 4 years now for the theoretical reasons I noted above and I can’t say that I have noted any difference grossly from the hair growth we received all those years using saline.

 

Mike Beehner, M.D.

[KO]

Koray Erdogan seems to use Hypotheromosol.

[KO]

There is a good presentation by a doctor, who is not mentioned on this site. Requesting permission from moderators to approve it.

 

 

It might be a decent idea to get Vitasol to spray after transplantation then?

[KO]

[Torn]

Since Dr Beehner mentions the use of Plasma-Lyte solution, I'd be interested to see what his yield percentages are ???

 

Presumably somewhere between 74 and 90%... and hopefully closer to the 90%

 

 

 

 

[WHTC-7706631290]

It's important for the patient to know this information, but only for the reason of ensuring that the performing clinic is competent. This factual information is the responsibility of the clinic to recognize for patients because it is their responsibility to produce the surgical results. Studying is a continual process and without studying all aspects of a surgical protocol, no progress can be made to further improve the results, techniques, and patient care process.

 

I appreciate this thread for its excellent information.