China: The novel histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine (HTK-AD) is superior to the conventional Ringer solution (RS) for hair graft preservation in hair transplantation needing long operative time, a randomized controlled trial has shown.
"The novel HTK-AD solution, compared to the Ringer solution, improved graft viability and prevented transient postsurgical hair shedding," researchers report in their study published in Dermatologic Surgery.
Live/dead staining showed greater cell viability in grafts stored in HTK-AD than in RS. Procedures using HTK-AD had a remarkably reduced incidence of postoperative hair shedding, decreased maximal percentage of shedding, and delayed shedding onset compared with the RS procedures.
Hair transplantation has gained popularity for treating alopecia. However, postsurgical hair shedding remains concerning for both patients and surgeons. Yong Miao, Nanfang Hospital of Southern Medical University Guangzhou, Guangdong Province, China, and colleagues, therefore, aimed to investigate the impact of the graft-holding solution on postsurgical hair shedding and testify to the protective efficacy of histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine (HTK-AD).
For this purpose, the researchers enrolled 240 patients, and the follicles were placed into HTK-AD or Ringer solution. Live/dead staining and Masson staining were performed to assess apoptosis levels and graft morphology, respectively. They performed a between-group comparison of postsurgical graft shedding, complications, survival rate, and patient satisfaction.
The study revealed the following findings· Grafts in HTK-AD maintained organized dense collagen construction and higher cell viability, but those preserved in RS became soft, which hindered implantation.
· Histidine-tryptophan-ketoglutarate solution with adenosine triphosphate and deferoxamine significantly reduced the incidence of postsurgical hair shedding (73.81% vs 95%), delayed shedding onset, and diminished shedding amount versus RS when ≥3,000 grafts were transplanted.
· The shedding duration was shortened, and hair regrowth started earlier in HTK-AD versus RS; thus, satisfaction was increased.
· The final survival rate showed no difference between the two groups.
"Our findings showed novel HTK-AD solution is more effective in preventing transient postsurgical hair shedding and preserving follicle grafts than the conventional RS in hair transplantation requiring long operative time," the researchers conclude.
Reference:
Zhou, Yi MD, PHD; Zhang, Jiaxian MD; Fan, Zhexiang MD, PHD; Hu, Zhiqi MD, PHD; Miao, Yong MD, PHD*. Evaluation of a Novel Graft-Holding Solution in Hair Transplantation: A Randomized Controlled Clinical Study. Dermatologic Surgery ():10.1097/DSS.0000000000003799, April 7, 2023. | DOI: 10.1097/DSS.0000000000003799