Question about Saline Spray Post-Surgery?

[FollicularlyChallengedScar]

Planning to use saline spray post-surgery because I think the Graftcyte and Biotin Spray are way too expensive and have too many chemicals in them.

 

Anyone know how often you are supposed to use the saline spray in the recipient area (every 30 minutes, every hour, etc.)?

[FollicularlyChallengedScar]

Planning to use saline spray post-surgery because I think the Graftcyte and Biotin Spray are way too expensive and have too many chemicals in them.

 

Anyone know how often you are supposed to use the saline spray in the recipient area (every 30 minutes, every hour, etc.)?

[mmhce]

Planning to use saline spray post-surgery

Do you mean a DIY home made saline solution in spray bottle or something bought from the drug store?

 

I should think that the same principle of epidermal/dermal topical rehydration should apply.

 

So if the instructions for Graftcyte is every 1hr, then you can transpose this instruction to such a saline solution/spray.

[Dr. Scott Alexander MD]

There is no reason to use Saline Spray on recently transplanted grafts. Saline doesn't cause any healing benefit at all. By keeping the area moist would only enhance the possibility of bacteria growing. The follicle itself is under the skin where it will stay moist with sterile body fluids. I would let the surface dry, form scabs, and let your body do its work. I think that Graftcyte is only necessary if you have large slits that need extra help for healing. If your slits are smaller than 1mm, you shouldn't need anything.

[HairHope]

Dear Dr. Alexander,

 

Thank you however I have been advised to use saline also, do you have any evidence regarding the use of saline post-op as harmful or is this just your observation.

 

A quick search shows many of the top doctors recommending this protocol post-op, thus I am extremely confused.

 

http://www.google.com/search?hl=en&q=saline+spray+post-op+hair+transplant

 

 

Appreciated.

[PLEASE GROW PLEASE]

Planning to use saline spray post-surgery because I think the Graftcyte and Biotin Spray are way too expensive and have too many chemicals in them.

Alot of clinics give graftcyte to you free.

I know Shapiro Medical does and remember a few other saying they do.

Nothing wrong with saline but it didnt seem to do anything as far as healing on my first botched surgery at Nuhart

[HairHope]

As an FYI, to make sure my saline is "pure" I bought this one.

 

http://www.medexsupply.com/pro...shSaline7ozspray.htm

[mmhce]

Alot of clinics give graftcyte to you free.

 

PGP,

Nothing is for free. You've paid for it somewhere down the line.

BTW, sorry about your deal with Nuhart.

[mmhce]

HairHope,

The saline product does not show the constituent ingredients. Any possibility of indicating what might be in it (K/Na salts etc.)?

[Maxxy]

Nothing is for free. You've paid for it somewhere down the line.

 

I agree, but it has raised a question.

 

Some clinics such as H&W offer a discount on procedures for travel and accommodation expenses. Do people living close to the clinic also recieve some form of a discounted rate? I wouldn't have thought so as it would make the reimbursement of travel/accommodation expenses futile.

 

Being from the UK, I obviously like the idea but doesn't it annoy people who live close to the clinics when someone from the UK or wherever, has in effect had 100s of dollars discounted for the same work?

[HairHope]

Originally posted by mmhce:

HairHope,

The saline product does not show the constituent ingredients. Any possibility of indicating what might be in it (K/Na salts etc.)?

 

 

Mmhce,

 

Here is the companies info: Wound Wash Saline?® is a non-prescription sterile saline solution (0.9% sodium chloride) designed for wound cleansing. Removing bacteria and debris is now painless and effective.

 

 

Hope that helps, any thoughts?

 

 

http://www.blairex.com/BLWoundWashSaline.php

[Steven Gabel, MD, FACS]

I feel it is extremely important for patients to keep their scalp clean after surgery. I provide patients with a spray bottle from the surgical procedure for two reasons: I want them to spray their scalp with the spray bottle to remove any blood or blood products that may have accumulated during the healing process as well as to keep the scalp clean. When blood and blood products accumulate on the grafts, a significant amount of crusting can occur which I do not think is healthy for the newly planted grafts. Once the blood products have stopped accumulating, I have them spray 1 to 2 times a day to keep the area clean.

 

The second reason I provide the patients with the spray bottle is for sterility purposes: during the case, we use the spray bottles to clean the surface of the scalp clear of blood. The spray bottles are exposed to blood products. Any instrument or supply that comes into contact with the patient is either new or been autoclaved. If we can't put the bottles in the autoclave, which insures that our instruments are sterile (the bottles melt ??“we tried this), then we have to throw the bottle out anyway. Therefore, I give my patients the spray bottle that we used for the procedure and we use new spray bottles for each patient. This insures that there is no cross-contamination between patients.

[Ringo]

Gentlemen,

 

I just had a meeting with Dr Feller last week in preparation for my 2nd HT, and I asked the question about the saline spray and graftcyte. he also claimed that it was an unnecessary expense, and added nothing to the healing process, since the grafts are safely under the skin.

 

Best,

Ringo

[Abedogg]

My doc suggested it. I used it and I think it definitely loosened up the scabs. They just came off at day 7.

I don't think its meant to keep anything moisturized. Its more to prevent the scabs from becoming too attached to the hairs.

[FollicularlyChallengedScar]

Originally posted by Steve Gabel, M.D.:

I feel it is extremely important for patients to keep their scalp clean after surgery. I provide patients with a spray bottle from the surgical procedure for two reasons: I want them to spray their scalp with the spray bottle to remove any blood or blood products that may have accumulated during the healing process as well as to keep the scalp clean. When blood and blood products accumulate on the grafts, a significant amount of crusting can occur which I do not think is healthy for the newly planted grafts. Once the blood products have stopped accumulating, I have them spray 1 to 2 times a day to keep the area clean.

 

The second reason I provide the patients with the spray bottle is for sterility purposes: during the case, we use the spray bottles to clean the surface of the scalp clear of blood. The spray bottles are exposed to blood products. Any instrument or supply that comes into contact with the patient is either new or been autoclaved. If we can't put the bottles in the autoclave, which insures that our instruments are sterile (the bottles melt ??“we tried this), then we have to throw the bottle out anyway. Therefore, I give my patients the spray bottle that we used for the procedure and we use new spray bottles for each patient. This insures that there is no cross-contamination between patients.

 

 

What day post-op do you have your patients discontinue use of the saline spray?

 

One week?

[Steven Gabel, MD, FACS]

My regimen is that I have them spray several times a day to keep any blood or residual serous fluid off of the scalp. Once the area stays clear of debris, then I have them cut it down to once or twice a day if needed.

 

To prevent drying out of the scalp, I have read that people use many different substances from Vit E solutions, mineral oil, Aloe, etc. I have patients, on day 4, put either Vit E or mineral oil on their scalp to prevent the grafts from crusting up. With this regimen, when patients return for the sutures to be removed, their scalp looks great and a majority of the crusting has already resolved.

 

Ringo: cost to the patient for the spray bottle: $0. I have to use the spray bottle during the case which is given to the patient at the end of the case. I agree that the use of Graftcyte is an unnecessary expense since that solution is around $75 - 100 ( don't have the exact figure as I don't recommend it as my patients have done well with excellent growth without it).

[PLEASE GROW PLEASE]

quote:

Nothing is for free. You've paid for it somewhere down the line.

 

Well since I actually paid the same possibly less then other clinics PLUS free extra grafts I consider it free .

I feel it helped alot but it could just be the tiny blades they used

[Dr. Scott Alexander MD]

With the tiny slits that we use for our recipient sites, they are sealed in the first 24 hours and as Dr. Feller states, nothing is going to penetrate the follicle to help it heal better. Grafcyte is used more for the scalp, but you have to understand that most of the peole using it are making larger slits. This is why they think it necessary to improve the healing of the scalp and to stop infection. At our clinic, we do not use anything at all post op. We allow our patients to shower the day after surgery, but we have them protect the grafted area from the pressure of the shower spray. We will allow them to rinse the area with cups of water after 2 days post op. As you can see from our results, the grafts heal just fine. You can also see from the comments that there are many ways to skin a cat. The most important thing is to not have an infection and to get good growth. Also you need to remember that as soon as that steril saline hits the scalp, it's no longer steril.

[Steven Gabel, MD, FACS]

Dr. Alexander - I agree with you that by using small slits that are custom made to fit the patient's graft size is optimal for several reasons including faster healing, less bleeding, and less trauma to the tissues. I also have my patients shower the following day after surgery - they do not let the shower directly hit the transplanted areas, but we have them rinse the area several times with water mixed with baby shampoo to clean the area off. We then have them come to the clinic on their first postoperative day to do a check of the transplanted area and donor site. Also, it is not about sterile saline, it is purely the action of the water cleaning debris from the scalp so the transplanted area is free of blood and blood products that can build up after surgery. This is most common on the first night, and quickly subsides after the first postoperative day.

 

It is well documented in the plastic surgery literature and, as you are aware of, the general surgery literature, that clean wounds lead to decreased infection rates; in fact, this is why hospitals employ nurses that sole responsibility is wound care and teaching. During my head and neck surgical residency and plastic surgery fellowship operating on hundreds of patients, we would spend a considerable amount of time on wound care and wound care instruction. It was clearly documented that patients who followed the directions and kept their incision sites clean had much better outcomes then those who neglected their surgical site.

 

And I agree with you: there is no one perfect solution; there are many ways to skin a cat and it is important to follow your physician's directions in the postoperative to achieve the best results.

[LondonTraveller]

If I may add my two cents (or two pennies??)

After I had my procedure, Dr Devroye asked me to spray with saline the following night every 20 minutes (no sleep allowed if you follow the guideline stricly)

 

And I did so. I have however never heard of another doctor, coalition member or not who recommends this.

 

From my own research,I understand this helps with crusting.

 

And for me it worked: I did not have any crusting at all. The only sign that I had had the procedure was a slight redness. This contrasts with the experience of crusting that most patients seem to go through.

 

I submit that the main benefit of the saline spray in my case was the post-op cosmetic appearance.

 

With regard to the 'wound care' referred to by the medical specialists on this thread, I would say that I was far more preoccupied with the wound in the donor area than the 'wounds' in the recipient. I started to shampoo extremely gently on day 2. I took great care to keep the donor clean and free of blood and used a small soft toothbrush for this as I knew that this promoted healing. No saline on donor though.

 

As I said, just my two pennies.

[Maxxy]

LondonTraveller,

 

 

After I had my procedure, Dr Devroye asked me to spray with saline the following night every 20 minutes (no sleep allowed if you follow the guideline stricly)

 

Are you sure you didn't misunderstand? I'm not doubting you but the above sounds a little over the top.

[LondonTraveller]

No, I confirm.

 

This is also on Dr Devroye's website (coalition member)post op instructions.

 

I also asked him also specifically at the pre-op consultation because I had spotted this on the website and this had surprised me, as it surprised you...

 

But anyway, I was not bothered because I doubt I would been able to sleep...

[Maxxy]

Yeah, I'm surprised they required you to do that - but as you said, it worked.

[LondonTraveller]

To spray or not to spray, that is the question...

[Dr. Glenn Charles]

All of the sprays you mentioned are relatively safe. You should spray a light mist 3-4 times per hour. I have been using a new product called H2Ocean spray which is purified ocean salt water with lysozymes. The patients healing time has been reduced.