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. 2024 Jul-Aug;99(4):568-577.
doi: 10.1016/j.abd.2023.08.012. Epub 2024 Mar 22.

Follicular unit grafting in chronic ulcers: a valuable technique for integrated management

Anahi Belatti  1 , Florencia Bertarini  2 , Virginia Pombo  1 , Luis Mazzuoccolo  1 , Damian Ferrario  1
Affiliations

Follicular unit grafting in chronic ulcers: a valuable technique for integrated management

Anahi Belatti et al. An Bras Dermatol. 2024 Jul-Aug.

Abstract

Chronic ulcers significantly affect the quality of life of patients and impose a high cost on the healthcare system. The therapeutic management should be comprehensive, taking into consideration the etiological diagnosis of the wound and the characteristics of the wound bed when deciding on a therapeutic proposal appropriate to the healing phase, correcting factors that delay healing. During the epithelialization phase, repair techniques with grafts are recommended to shorten re-epithelialization time, improve the quality of scar tissue, and achieve adequate pain management. Currently, due to the reported benefits of skin appendages, the technique of follicular unit auto-grafting obtained with a scalp punch is among the chosen strategies for wound repair. This is a minimally invasive, outpatient practice, whose technique has advantages over the donor site, patients recovery and well-being.

Keywords: Follicular unit; Hair follicle stem cells; Hair transplantation; Punch grafting; Skin grafting; Venous leg ulcer; Wound healing.

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Figures

Figure 1
Figure 1
Quick view for the calculation of follicular units (FU) per ulcer area to be treated (UA, Ulcer Area; SC, Scalp Area).
Figure 2
Figure 2
Harvested follicular units (FUs).
Figure 3
Figure 3
(A) Circular defects after extraction of follicular units. (B) Evolution of donor area healing at 72 hrs.
Figure 4
Figure 4
Close-up view of grafts implanted in the ulcer bed on the leg.
Figure 5
Figure 5
Sequence of Coverage and adapted multi-layer bandage. (A) Petrolatum-infused gauze, (B) Dry gauze, (C) Dressing, (D) Gauze bandage, (E) Ovate bandage, (F) Elastic wrap.
Figure 6
Figure 6
Practical illustration of the follicular units (FU) graft sequence.
Figure 7
Figure 7
Sequence of healing process after follicular units (FU) graft on the leg. Medical appointment days: (A) 06/10/2021, (B) 07/15/2021, (C) 10/17/2021, (D) 11/11/2021.
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