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LETTER TO EDITOR
Year : 2020  |  Volume : 12  |  Issue : 3  |  Page : 135-136  

“Blister ring hydration”: Innovative use of medicine blister pack to prevent desiccation of follicular grafts


Department of Dermatology, Command Hospital (SC), Pune, Maharashtra, India

Date of Submission23-Apr-2020
Date of Decision20-Jul-2020
Date of Acceptance21-Jul-2020
Date of Web Publication14-Aug-2020

Correspondence Address:
Lt. Col. (Dr.) Vikas Pathania
Department of Dermatology, Command Hospital (SC), Pune - 411 040, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijt.ijt_65_20

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How to cite this article:
Pathania V, Sandhu S. “Blister ring hydration”: Innovative use of medicine blister pack to prevent desiccation of follicular grafts. Int J Trichol 2020;12:135-6

How to cite this URL:
Pathania V, Sandhu S. “Blister ring hydration”: Innovative use of medicine blister pack to prevent desiccation of follicular grafts. Int J Trichol [serial online] 2020 [cited 2020 Sep 30];12:135-6. Available from: http://www.ijtrichology.com/text.asp?2020/12/3/135/292102



Sir,

The identification of various factors affecting follicular graft survival in hair restoration surgery has received considerable attention over the past decade. During surgery, follicular grafts are subjected to various stresses such as dehydration, mechanical trauma, hypoxia, adenosine triphosphate depletion, reperfusion injury, cold injury, and lactic acid accumulation.[1] Limmer in his in vivo study on the relation of “out of body time” and survival of grafts where he used chilled saline as holding medium has described the loss of 1%/h on an average.[2] Novel techniques such as direct hair transplant (DHT) can reduce “time out of body” to as less as 5–10 min.[3] However, inadvertent and inevitable desiccation of grafts awaiting implantation despite continuous hydration remains a challenge for any hair transplant team.

We describe a cheap and innovative modification of a single blister pack of a cylindrical tablet as follicular graft storage unit (well) which aims to provide adequate hydration of grafts awaiting implantation in the premade “slit and place” method of hair restoration surgery. We used a single cut out tinted, plastic blister pack of tablet albendazole 400 mg measuring 2 cm × 1 cm with 1 cm depth in this instance [Figure 1]. The blister pack was emptied of its contents, de-capped, cleaned, and sterilized with ethylene oxide (ETO). Thereafter, it was secured to the index finger of the nondominant hand with a presterilized micropore dressing, following which a window was cut out through to fashion a well [Figure 2] and [Figure 3]. At a time, an aliquot of 15–20 follicular grafts was transferred from the main reservoir and kept bathed in chilled saline while awaiting implantation. The tinted dark background of the blister helped easy visualization of the white fleshy grafts and hence minimal handling of graft as well [Figure 4]. The blister pack once secured was found to be durable to last throughout a single procedure without breakage or leak. However, the temporary and delicate nature of the apparatus renders itself to inconsistencies in reproduction.
Figure 1: A single medicine blister with tablet removed

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Figure 2: Application of micropore tape to the blister for anchorage

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Figure 3: Securing the blister well over the index finger of non-dominant hand and creation of a window

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Figure 4: “Blister hydration ring” aiding viability and expediting implantation of grafts

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The contraption highlights a simple and cheap innovation which minimizes desiccation of follicular grafts while maintaining “time out of body” and minimal handling of grafts, thereby increasing their viability. Most importantly, it can be easily fashioned from disposable items which are ubiquitously available in any operation theater.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot bechrological order guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Parsley WM, Perez-Meza D. Review of factors affecting the growth and survival of follicular grafts. J Cutan Aesthet Surg 2010;3:69-75.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Limmer R. Micrograft survival. In: Stough D, Haber R, editor. Hair Replacement. St. Louis: Mosby Press; 1996. p. 147-9.  Back to cited text no. 2
    
3.
Sethi P, Bansal A. Direct hair transplantation: A modified follicular unit extraction technique. J Cutan Aesthet Surg 2013;6:100-5.  Back to cited text no. 3
[PUBMED]  [Full text]  


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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