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PRP and FUE in Hair Transplantation


Hair transplantation, issues and controversies are relatively new. The issues refer to ethics and evidence and how practitioners and the public have to deal with them. This article does not deal with dozens of different issues such as follicular unit transplantation compared to a follicular unit deficiency, donor safe area, plasma rich in platelets, and minimum quality for hair transplantation.

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Plasma is filled with platelets in Hair Plantation

Platema-rich plasma (PRP) is a platelet rich fiber matrix (PRFM), plasma rich in growth factors (PRGF), and platelet plate (PL), and new therapy based on biotechnology cell, there is an increasing interest among patients and surgeons. This therapy is defined as the automated preparation of plasma with concentrated activated platelets. There are various factors of growth (GFs) and cytokines in the PRP that contribute to the body’s basic ability to repair and regenerate. PRP was claimed to have a therapeutic effect for androgenetic alopecia (AGA) in some studies. This discussion will focus on the use of PRP in hair transplantation (HT).

PRFM is a new phase in the concept of platelet therapies using anti-electrodes and gel instead of solution. In the PRFM preparation process, a matrix such as gels, containing a high concentration of platelets is nonactivated, functional, intact present within a fibrin matrix that releases GFs constantly over a longer period. In the PRFM, the fibrin matrix is ​​well formed and effectively guides the stem cell migration to the injury site.

Where a PRGF agent was added to the PRP solution and incorporated for 1h. The loose warden was stored following the rebuilding of fibrous fiber and centrifugation (1000g, 10min) at -80 ° C. This solution was found to be rich in the release of platelets from platelets.

To prepare it, a PRP collected for 30s / 30s was specified and kept at 4 ° C. The total specification time was set to 30min. When the final cycle was completed, the platelet samples filled for 10min at 1967 × g were centrifuged, and the upper solution collected was given as PL. PL is to be rich in GFs. PRP, PRFM, PRGF, and PL in HT were used at various stages to improve the results.

PRP was used in the following steps in HT,

  • As a holding solution on the grafts
  • Injection of PRP in the recipient’s area before the deviations are made
  • Injecting into the recipient area immediately after making the slots
  • Timely implementation over the grafted site
  • Injection into the recipient area immediately after implanting grafts at the end of surgery
  • Injection into the recipient area after surgery in several sessions over several months to improve the growth of the hairs engraved

Limited literature evidence is available to record the safety and efficacy of PRP and PRFM therapy in hair transplant surgery. The system and protocol for PRP and its effectiveness are currently a very relevant topic and discussion, particularly in relation to social media, and it is very difficult to present it in an honest and fair way to patients. . Many variables include systems used to produce PRP, whether or not A-Cell is introduced, whether it is externally activated or not, how it should be injected, whether microroller is important, and what are the ideal concentrations are the different blood components, the amount of PRP that must be injected, its duration and distribution.

In 2006, was one of the first reports on the use of PRP for hair transplant surgery. Follicular units (FUs) were first immersed in PRP for 15min and then 10 drops of 10% calcium chloride were added to this mixture of paste in PRP solution after 15min. This transfused fibrinogen into fibers, providing the plasma jelly to seal the GFs across the micrografts, which were then inserted. They noted that the yield on FUs had improved significantly at 7 months on the first spent with PRP compared to the PRP controlled side. In vitro studies have shown that PRP encourages a significant initiative and an extension of the hair growth cycle. It also helps to stimulate the angiogenesis, which improves growth and medicine.

Garg carried out an evaluation of the outcome of PRP therapy which was injected internally during the follicular unit deficits (FUE) in a randomized study on 40 FUE hair transplant materials, allocated in two groups (PRP and non-PRP) each. The PRP was injected indirectly after the creation of slices across the recipient area in a PRP group and the normal saline group in non-PRP. Two groups were assessed at 2, 4, and 8 weeks, 3 and 6 months from the procedure. The study concluded that interoperability PRP therapy is beneficial in terms of faster growth, reducing catagen loss of transplant hair. It could also help to recover faster the recipient area and to activate dormant follicles also in FUE transplant materials. PRP therapy can improve the skin milieu of the place that is affixed to cell growth and by differentiation, antipoptic activity, and neovascularization by making a more open and fertile adhesive area for newly replanted hair. It could also help provide a friendly environment for dormant hair follicles leading to anagen new hair activity and appearance as early as 2 months. The loss of catagen in transplant hair was greatly reduced, leaving earlier results.

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