In this blog entry I will discuss my approach to harvesting the donor strip in the strip harvest procedure. Firstly I always try and limit the width of my donor strip to no more than 15mm and this is usually in the area of the scalp with the most laxity. In areas of the scalp where there is less laxity I routinely taper the strip with even less width. The length of the strip is determined by the amount of follicles we are looking to harvest in the session. I only use sutures to close the donor strip. I believe the donor region heals much better with sutures rather than staples and a fine thread suture is definitely more comfortable to sleep on than a row of bulky metal staples on the back of the head. I routinely employ a tricophytic closure when closing the donor region. The involves shaving less than a mm off the lower edge of the donor closure. This transects the follicles on the skin edge thus causing hair to grow through the donor scar and making it even more invisible. In cases when I know the patient is coming back to see me in the near future for a repeat procedure I will not perform a trichophytic closure as you can permanently damage some donor follicles by performing this procedure, so in the interest of maintaining the maximum amount of donor follicles for future procedures I like to wait until the patient is close to the end of his treatment before I employ this technique. When patients present for a second or third procedure I always try to include the old donor scar within my new incision so that the patient is left with only a single linear scar as opposed to “train tracks” running through the back of their scalp. I have included some photos of typical donor scars on my patients.
All the best,
Marc Dauer, MD