Views Article
Hair Transplant Forum International 2002; Volume 12, No. 2, p43.
Post-Hair Transplant Protocols
Robert M. Bernstein, MD New York, New York
We have the patient shampoo twice the day following surgery, twice daily for the next three days, and then daily until their one-week post-op visit. We give the patient one bottle of GraftCyte Shampoo and have them continue it until it is used up. Once the GraftCyte is finished, they are instructed to resume their regular shampoo. We use GraftCyte because we know that it is not damaging to grafts and it is much simpler than having to recommend specific mild shampoos to the patient. It is also nice for the patient not to have to go out to buy a shampoo post-op. On the other hand, with the very small sites that we use in Follicular Unit Transplantation we have not found the full GraftCyte protocol to be useful in promoting wound healing. In fact, some patients (perhaps 5-10%) seemed to get irritated from the treatment and became pruritic and hyperemic.
In the donor area, I much prefer a simple antibiotic ointment, such as Bacitracin, or petrolatum, as GraftCyte gel is drying and seems to accumulate in the hair. In my opinion, it does not provide the moist environment around the sutured donor incision that is optimal for healing.
We used the full GraftCyte protocol for about a year. Since we did not see any benefit that either warranted the cost or the post-op fussiness of the full protocol we discontinued it for routine use. We still keep the full pack on hand in the office for patients that, for one reason or another still want to use it, but that is extremely rare.
I do not like to use saline sprays, either during surgery or post-op, as I am concerned that, as the water evaporates, a hypertonic residue will be left on the scalp that might be damaging to grafts. I think that dilute hydrogen peroxide and water is the best for cleaning the scalp while making recipient sites, but prior to graft insertion. Plain water is best to clean the scalp once placing is begun (we hold the grafts that are waiting placement in chilled Lactated Ringer's solution). Post-op, I prefer the plain water and irrigating benefits of a gentle shower.
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