| Hair is the physiological part of the beauty for human. With the improvement of living standards, people have a improved require of beauty. Healthy hair can enhance a person’s self-confidence. Hair loss is a common illness, although not a serious disease, but have a greater impact on people’s mental, psychological. Therefore, the diagnosis and treatment of alopecia are becoming more urgent, modern medicine has pay more and more attention to the study of hair loss. The type of hair loss including androgenetic alopecia, scarring alopecia, congenital alopecia and alopecia areata. Clinical hair restoration technology for its effective and durable, the majority of alopecia in patients with recognized. The technology can be divided into alopecia scalp reduction techniques scalp expansion surgery scalp autograft hair follicle cluster transplantation and units of the hair follicle fiber transplantation. Small area of hair loss patients in hair follicles and micro-grafting is the treatment of the most common applications, the use of the technology enables the re-distribution of hair follicles in alopecia region, and can basically reach a more satisfactory long-term operation after the appearance. Therefore, in recent years has been widely used in hair, eyebrows, beard, and even the repair of the pubic hair. But no matter what kind of repair techniques, are sufficient autologous donor area hair as a precondition, the source of their hair relatively limited, even for a large area of hair loss in patients with alopecia totalis patients, the technology exists for the District the hidden danger. At the same time, left over from the donor area permanent scar, the survival rate of transplanted instability significantly affect the long-term effects of the technology. Many alopecia patients with hair loss is progressive, hair restoration can not be reversed or stopped, but can not forecast to develop circumstances. So, how to provide more hair source of today’s hair restoration surgery is more difficult to solve the problem. The hair follicle tissue engineering in recent years on this issue in-depth investigate and research and made some progress, already through to the murine and human source of the hair follicle cells rebuild the hair follicles, but by the subculture of dermal papilla cells and hair follicle stem cells decreased, difficult to obtain cells with high activity. But their research is still in the case of the laboratory research stage, and not really involved in clinical work. In this context, artificial hair transplantation brings hope for the solution of these problems.To solve the serious shortage of clinical needs, the domestic and foreign researchers are exploring and researching artificial hair actively. The concept of artificial hair transplantation was first proposed by the Japanese scholar in1976. However, Artificial hair implantation had fallen into disfavor following a string of disastrous complications and complete fiber fall within10weeks of implantation in almost all the patients in the early1970and1980s.Unfortunately, the fibers employed in the past were unsterile, allergenic and some were coated with toxic dyes. Observations and scanning electron microscopy had identified the artificial fibers used in the past as mainly modacrylic fibers found in wigs, synthetic furs as well as fire and chemical resistant clothing. These were vinyl halide polymers composed of35%to85%acrylonitrile. Vinyl halide and acrylonitrile are carcinogens, as is the diaminoanisole dye used to tint these fibers. Almost all of the graft at10weeks off, even accompanied by including persistent facial swelling, cellulitis, induration of the scalp, permanent scarring and persistent hair fall off naturally, including serious side effects and permanent sequelae. However, because of its simple operation, without the restrictions of the donor site and postoperative appearance advantage, all the researchers have been not to give up to improve artificial hair. In1996, the Italian scholars created a biofiber synthetic fibers (polyamide artificial hair fiber). Subsequently, the other foreign scholars use this fibers in clinical to repair repair alopecia.They observed its histocompatibility are very well and could be considered for the repair of a large area of alopecia. But through long-term clinical observation and returning found that the polyamide artificial hair fiber’s long-term stability about20%-25%. This shortcoming brought great inconvenience to the lives of the majority of patients, therefore still can not really satisfy the patients. Our department laboratory research and development Follicular Unit-like Wigs (polypropylene artificial hair) independently since2005, after two generations of technological improvements, this wigs have been applied to animal experiments and clinical studies. Two kinds of artificial hairs’compatibility and long-term effect are still worth to explore.In this study we observed the appearance of polyamide artificial hair fibers and human hairs very similar. To the one end with a slipknot, use an appropriative transplant pen hooked the slipknot can accurately transplant fibers into the scalp. With the transplant needle depth into the scalp, slipknot sliding taut, fixed under the scalp. So we proposed using ophthalmic tweezers and needle holder to resort to a surgical knot above the slipknot, when the line of junction formed in the fiber taut than before doubling to more solid polyamide artificial hair fiber is fixed to the scalp. Which can reduce its long-term expulsion rate. Histocompatibility complex and long-term effects were observed after the implantation of polyamide artificial hair fiber, we hope the fibers can widely be used in clinical as a new therapy for diseases of hair missing.Materials and Methods1.The experiment materials and equipmentPolyamide artificial hair fiber (shenzhen tianLin industrial Co., Ltd, CE0373/TGA, Medicap Ltd., Carpi (MO) some), transplant pen (Medicap Ltd authorization, shenzhen day Lin industrial Co., Ltd), is a needle, eye tweezers, pressure steam sterilizer, optical microscope, biological microscope.2.Improve the fixed knot of polyamide artificial hair fiberPolyamide artificial hair fiber appears as similar as human hair, its end even have a slipknot, with transplant bending written with the needle hook type head off the head of the slipknot live can be accurately fiber transplantation into the scalp. With the thorough into scalp transplant needle, slipknot sliding taut, fixed in the scalp. We use eye tweezers and the needle holder tie a surgical knot above the original slipknot, so that when fiber taut line and the formation of the previous increase one times, it can be a more solid fixed in the scalp. The fibers in this experiment is black, the length is15cm.3.Polyamide artificial hair fiber transplantation of animalsSelect New Zealand big white rabbit, as an experimental animal, it will be randomly divided into A, B two groups, A group as control group, do the conventional method transplantation; B group, and do improved method transplantation. The rabbits were anaesthetized with3.0%sodium pentobarbital (30mg/kg) and immobilized on an operating table with adhesive tape; Use a needle hook live polyamide transplant artificial hair fiber knot, implanted developing white rabbit skin to subcutaneous, depth of2-3mm. Each rabbit take developing two area transplant, a general observation area, another area do histologic observation. Each area were implanted50fibers, single rabbit were implanted100fibers. After the completion of the transplant of fiber length of clip exposed, single gauze gently cover transplant tissue, the second day will take it.4.Polyamide artificial hair fiber of the long-term fall off rate observationThe wound healing of these slits postoperative, was evaluated for swelling, ulceration, and infection. The appearance of the wigs was also evaluated. The loss rate of wigs was calculated at1week,1month,3months,9months, and12months following transplantation. The total loss rate was calculated at12months.5.Polyamide artificial hair fiber histological observationBiopsies in all the10rabbits were performed at1week,1month,3months,9months, and12months after implantation under sterile conditions. The specimens were fixed in10%formalin, paraffin-embedded and sectioned according to established protocol in our lab. The histological changes around the Polyamide artificial hair fiber in those specimens were studied by H&E staining.6.Statistical analysisThe data were statistically analyzed by SPSS16.0software. The data of the expulsion rate between conventional fiber and improved fiber were analyzed by variance, P<0.05was considered statistically significant.Results1. After transplantation, the polyamide artificial hair fiber looks like the human hair. The transplanted fibers’direction are good, they distributed of natural appearance, the result is satisfactory. Postoperative instant around the transplant hole we can observed mild bleeding red and swollen. After transplantation a week later all the holes are healing, rabbit hair around the fibers are growing normally. After transplantation a year later we can’t see the transplanted scar, there is no burst, ulcer and erosion around the fibers and scalp.2. Observe the control group and the experimental group can be found that in a month after transplantation some of grafts had been lost, which mainly concentrated in a week after transplantation, then with the surrounding skin tissue around the polyamide artificial hair fiber and the fixed knot anchoring, the amount of fell fibers were reducing gradually, after6months there are no longer had fibers fell up basically. We observed the fibers1years later, the average loss rate in control group (group A) is about24-2.4%, and the average rate in experimental group (group B) is about10-3.1%, there was significant difference between them (P<0.0001).3. There were mild inflammatory infiltration by neutrophils and lymphocytes and small vessel congestion in1week after implantation. Multinucleated giant cells were observed around the polyamide artificial hair fibers. Slight epithelial cell proliferation was observed around the hair fibers. Neutrophils. lymphocytes, and multinucleated giant cells were reduced in1month while fibroblasts increased and more epithelial cells surrounded the hair fibers. No significant histological changes were evident in3to9months following implantation no pigmentation. In comparison with the changes at first week, the infiltration by inflammatory cells almost disappeared. The formation of fibroblasts and collagen fibers surrounded the polyamide artificial hair fibers had strengthened. Much more epithelial cells were present around the hair fibers. At12months, many fibroblasts and collagen fibers were seen around the polyamide artificial hair fibers.ConclusionIn summary, we are using ophthalmic tweezers and needle holder to improve the fixed knot of polyamide artificial hair fibers, increasing the size of the fixed knot. Get though the animal experiments, we observed that Polyamide artificial hair fiber had a good histocompatibility. Increase the size of the fixed knot will not cause more intense tissue rejection. And the transplanted fiber looks similar with the real human hair. The expulsion rate of improved fiber are greatly reduced. This is likely to provide more treatment options for patients with large area of baldness or alopecia totalis in the future. The polyamide artificial hair fibers can be customized according to the patient’s own hair length and color, which used to repair a large area of alopecia, The method will shorten the patients’surgery time, reduce the patients’ pain. And it can eliminate the procedures of hair follicle extraction for clinical hair transplant surgeon, which can bring great convenience for clinical work. |
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