LETTER TO EDITOR

Year: 2019 I Volume: 2 I Issue: 3 I Page: 87

A method to maintain a clear, bloodless surgical field while making slits during hair transplantation

1 Dermatology Department, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai 22

Corresponding Author:
Dr Aseem Sharma
Dermatology Department, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai 22

How to cite this article:
Dhurat R, Agarwal S, Sharma A, Jage M, Kona SN, Mahobia S, Surve R, Daruwalla S. A method to maintain a clear, bloodless surgical field while making slits during hair transplantation. JDAIndian Journal of Clinical Dermatology. 2019;2:87.

Sir,

During hair transplantation surgery[1], a surgeon makes slits at the recipient area before implanting follicular grafts. The slit-making results in bleeding, which obscures the surgical field and makes it difficult to make more slits, as blood gravitates to the field. To combat this, a few surgeons use tumescent anaesthesia with adrenaline, to minimize the bleeding while making slits[2]. In a few patients even after this, bleeding occurs which is enough to render further slit-making difficult, as the site is covered with blood.

Hence, the recipient area is marked with a surgical maker. After local anaesthesia, incisions can be made starting at the frontal hairline. In other areas, slits can be made starting at the lowermost part of the recipient area, to facilitate gravitation of the blood. In this manner, blood will drip away from the surgical field, or over the area where implantation has been completed, and not over the site where further slit-making is to be done. Additionally, gauze is dabbed over the freshly made slits, to compress them and minimize bleeding, and further slits can be made above them. In this manner, the surgical field will stay clean, graft implantation will be faster, and slits will be more accurate. (Figure 1 and 2)

Figure 1: Demonstration of slit making.

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Figure 2: The bleeding in incisions at lower area is not obscuring the area above these slits

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References:

1. Rose PT. Hair restoration surgery: challenges and solutions. Clin Cosmet Investig Dermatol. 2015;8:361370. Published 2015 Jul 15. doi:10.2147/CCID.S53980

2. Khanna M. Hair transplantation surgery. Indian J Plast Surg. 2008;41(Suppl):S56S63.



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