BACKGROUND. The most common type of donor closure in hair transplantation i
s with nonabsorbable, running sutures, usually of nylon or polypropylene, T
his is accomplished with or without buried absorbable sutures, Another popu
lar method of closure is with stainless steel staples, Each of these method
s has benefits and limitations with respect to healing, comfort, and conven
ience for the patient.
OBJECTIVE. The purpose of this study is to describe the use of poliglecapro
ne 25, a synthetic, absorbable, monofilament suture in hair transplantation
surgery, to detail the suturing techniques needed to maximize the benefit
of this suture, and to compare this material and suturing technique to a we
ll-established form of closure, that of metal staples in a bilaterally cont
rolled fashion.
METHODS. Poliglecaprone 25 is a synthetic, absorbable monofilament suture o
f low tissue reactivity. It was compared to closure with metal staples in a
bilateral controlled study, One side of the donor area was closed with pol
iglecaprone 25 sutures using a running cutaneous stitch and the other side
was closed with stainless steel staples, patients were evaluated with regar
d to healing, postoperative discomfort, resultant surgical scar, and closur
e material preference.
RESULTS. Of the 22 patients studied, the following postoperative complaints
were noted on the staples side: tenderness (12), itching (4), swelling (2)
, and scabbing (1). This compared to only one complaint of itching and one
complaint of swelling on the poliglecaprone 25 side. Two patients had posto
perative complaints of visibility of staples showing through their hair. Ob
jective measurements revealed a wider scar overall on the staples side in s
ix patients and wider scar on the suture side in two patients. The average
scar width on the staples side measured 1.78 mm compared to 1.42 mm on the
suture side. Fourteen of the 22 patients preferred poliglecaprone 25 for fu
ture procedures, 1 preferred metal staples, and 7 had no preference. Most p
atients stated that postoperative discomfort from the staples and the incon
venience and occasional pain associated with their removal was responsible
for their decision.
CONCLUSION. Poliglecaprone 25 is a strong synthetic, absorbable, monofilame
nt suture with low tissue reactivity that can be used in hair transplantati
on to close the donor wound with a single, running cutaneous stitch. This s
uture can provide a donor closure that ensures hemostasis, has little risk
of infection, and is comfortable for the patient. If specific surgical tech
niques are followed, this suture can provide a donor closure that ensures h
emostasis has little risk of complications, is both comfortable and conveni
ent for the patient postoperatively and results in a fine surgical scar.