Using skin graft substitutes for donor scars?

[possiblymaybe]

Hi, I haven't gotten a hair transplant and am still learning a lot, but I am wondering why donor scars couldn't be filled in using a skin graft substitute like Alloderm, TransCyte, etc... Intercytex also has a skin graft subsitute called ICX-SKN which seems promising but is in clinical trials still.... I think it makes a lot of sense. Of course I have no idea what the cost of those materials are.

 

Any thoughts?

[dakota3]

Very good question! Maybe 1 of the docs that frequent this forum can answer

[Dr. Timothy Carman]

possiblymaybe-

Good question. In general, split-thickness-skin grafts (STSG) or skin graft substitutes are utilized in surgery primarily when there is a large defect or absence of epithelium (skin) due to any number of factors (eg, tissue avulsion injuries, burns, the after effects of severe skin infections, etc.). What all these insults result in is the same: loss of a skin layer over existing subcutaneous tissue (fat, muscle, etc.). This is a different situation from the condition that results from removing a donor strip from the back of the scalp. There, along with the full thickness of skin, subcutaneous tissue is removed, and the two skin edges (and subcutaneous tissues) are re-approximated. The developement of scar tissue is a natural process, the remodeling goal of which is to actually shrink the incision site over time. Factors that play against this, and may result in a larger scar are;

1) Increased closure tension across the wound

2) Loss of hair follicles along the skin edge due to transection during donor harvest

3) Unusual wound healing characteristics unique to an individual patient (hypertrophic or keloid formation).

In general, to minimize scar formation and encourage healing, we recommend neosporin ointment applied twice daily for the first two weeks following surgery, followed by a good moistening agent such as aquaphor once daily.

So you see, there is no "filling in" that needs or could be accomplished as your question poses.

Does that make sense?

Hope that helps.

 

Sincerely,

 

Dr. Timothy Carman

[possiblymaybe]

Thanks for the speedy reply. I guess I was thinking of grafts for filling in the holes created when doing punch excisions on the back of the head to remove a group of follicles... Maybe I just don't know what I'm talking about, but I see lots of photos of dudes with little bloody holes on the backs of their heads at the donor site and I assume they're just going to end up as pits? Or maybe sutured closed, leaving little indents?

 

Thanks again!

[Dr. Timothy Carman]

possiblymaybe-

I believe you are referring to FUE extraction-

So yes, while in that case there IS technically a loss of epithelium, the punch sizes used to extract individual follicular units are so small that the body can and does epithelialize over these small surface areas. There is no pitting, per se; that deformity usually comes from large punch graft excisions(no longer performed)which are sewn closed aggressively.

 

Dr. Timothy Carman