Syringes versus Chinese cups in harvesting suction-induced blister graft: a randomized split-body study.

BACKGROUND: Suction blister grafting (SBG) is a technique where the pigmented epidermis is harvested from the donor site by induction of a blister using different suction methods as syringes, Chinese cups, suction device, etc. However, pain, time consumption, incomplete blister formation, and failure of blister development are the main limitations. OBJECTIVE: To compare between cups and syringes of similar diameter in inducing suction blisters. PATIENTS AND METHODS: In 30 patients with stable nonsegmental vitiligo, 2-cm-diameter (20 ml) syringe was applied on the anterolateral aspect of one thigh and a 2-cm-diameter cup on the corresponding site of the other thigh where right and left sides were chosen randomly. Patients were observed untill complete blister development or for a maximum of 3 hours. Suction blister induction time (SBIT) and the blister diameter were recorded for each patient. Pain during the process of induction was evaluated. RESULTS: Incomplete blister development was noted in 9 out of 30 (30%) with 2 cm syringes and 6 out of 30 (20%) with the similar diameter cups with no significant difference (P = 0.49). No significant difference was found between SBIT induced by the 2 cm syringes and the similar size cups (101.17 ± 68.14 minutes, 98 ± 56.84 minutes, respectively) (P = 0.85). Meanwhile, blister diameter induced by either syringe or cup was not significantly different (P = 0.37). Anesthesia was for short duration with xylocaine, and pain was intolerable in both sides in the first seven patients. A combination of xylocaine and bupivacaine was used with prolonged loss of pain in 17 of the remaining 23 patients and tolerable pain in six patients similarly in both sides. CONCLUSION: According to present results, the differences in SIBT, diameter of blisters, and number of complete blister formation induced by either syringes or cups of similar size were not significant. Therefore, whatever the available and feasible technique for the surgeon will be the ideal choice. A combination of xylocaine and bupivacaine is recommended to overcome the accompanying pain of the procedure.

The latest innovations in hair transplantation.

Hair restoration began as a result of the fortuitous finding by Dr. Norman Orentreich that hair follicles taken from an area of nonbalding scalp could be implanted into an area of male pattern hair loss and continue to grow terminal hair. Since that time, hair transplants have progressed from the use of large plugs to the use of follicular units (normally occurring clusters of hairs). This has allowed surgeons to create undetectable results in cases of androgenetic alopecia and well as other conditions associated with hair loss. Advances continue in hair restoration technique ranging from surgical approach to instrumentation and ways to enhance growth. In this article, the more recent surgical and medical innovations in hair reconstruction are reviewed.

Management of split skin graft donor sites--results of a national survey.

UNLABELLED: The authors wished to obtain a 'snapshot' of the range of practice in the management of split skin graft donor sites in the British Isles. MATERIAL/METHODS: Questionnaires were sent to all British consultants and locum consultant plastic surgeons on 1 July 2006. Of the 357 questionnaires, 279 were returned (a response rate of 78%). RESULTS: Alginates were the most popular dressings, especially in adult donor sites--first choice for 167 respondents (60%). Adhesive fabrics were less popular--first choice for small adult donor areas for 46 respondents (16%). Plastic film dressings and Biobrane were even less popular--being the first choice for small and large donor areas, respectively, in children (for approximately 5% of respondents). Ten percent of respondents said they avoid paraffin gauze and another 10% avoid plastic film dressings in all cases. Five percent avoid hydrocolloid and another 5% avoid adhesive fabric in all cases. CONCLUSION: On the basis of these results, we feel that any future study of donor-site dressings should incorporate the most commonly used dressing (alginate) as a control.

Chinese cupping: a simple method to obtain epithelial grafts for the management of resistant localized vitiligo.

BACKGROUND: The introduction of surgical techniques provided a major development in the management of resistant vitiligo and replaced other conventional unsuccessful therapies. Most of these procedures require special devices and experience that prevent many dermatologists from utilizing them. OBJECTIVES: The aim of this work is to evaluate the introduction of a new simple technique that can be used in epithelial grafting for recalcitrant patches of vitiligo. METHODS: Twenty vitiligo patients, nonresponding to classic phototherapy, were candidates in this study. A simple Chinese cupping device was used to induce blisters on the inner aspect of the thighs of the patients and the resulting blister roofs were used for grafting on dermabraded vitiliginous patches. The patients were followed up for 1 year. RESULTS: Blister roofs induced by Chinese cupping were able to repigment vitiliginous patches in 80% of the patients with admirable coloring match, and the donor areas did not show any cosmetic disfigurement at the end of the study. CONCLUSION: In conclusion, Chinese cupping is a simple and easy-to-use method to obtain epithelial grafts for vitiligo management. The author has indicated no significant interest with commercial supporters.