A comparative study of suction blister epidermal grafting and automated blister epidermal micrograft in stable vitiligo

Abstract

The automated blister epidermal micrograft (ABEM) is a newly introduced surgical transplantation for refractory vitiligo. Comparative analysis of other surgical methods is lacking. We conducted a retrospective study to compare the efficacy, safety, and experience of ABEM with conventional suction blister epidermal graft (SBEG). A total of 118 anatomically based vitiligo lesions from 75 patients were included. The primary outcome was the degree of repigmentation; the patient and operator experience were evaluated. SBEG had a significantly greater incidence of repigmentation (p < 0.001), as measured by the Physician Global Assessment, as well as improvements in the Vitiligo Area Scoring Index, particularly on the face/neck area (p < 0.001). ABEM, on the contrary, had reduced donor harvest time, a better patient operative experience, and more significant Dermatology Life Quality Index improvements. In a subgroup of 38 lesions from ten patients who received both SBEG and ABEM concomitantly, there was no difference in the degree of repigmentation in the same recipient area. Overall, the degree of repigmentation for SBEG is higher than ABEM, especially in the mobilized region, and the cost is less expensive. On the contrary, ABEM requires less procedure learning curve and can supply a greater transplanting zone with shorter donor site recovery. Understanding the benefits and drawbacks of two blister grafting procedures is essential for optimal surgical outcomes for vitiligo grafting.

Long-Term Effects and Prognosis Following Suction Blister Epidermal Grafting in Vitiligo Patients

“…These results were consistent with previous studies. 5,6 Postoperative AEs at the recipient site, such as erythema, pain, and itching, generally resolved within 1 month without requiring treatment. It was noted that 74.7% (189/253) of patients experienced perigraft halo and 46.2% (117/253) had persistent halo, which was slightly higher than those reported in the literature.…”

“…The main AE in the donor site was cobblestone-like pigmentation in 73.1% (185/253) of cases, and in 28.9% (73/253) of patients, the pigmentation persisted for more than 2 years without regression. In 2022, Gao et al 6 used the traditional negative pressure blistering method to extract 62 blisters and observed their AEs, and they observed that the cobblestone-like pigmentation in the blister area took an average of approximately 13.71 months to regress. The authors concluded that cobblestone-like pigmentation in the donor site is a common AE of SBEG, and it takes a long time to regress.…”

Disease Awareness and Treatment Preferences in Vitiligo: A Cross-sectional Study in China

“…According to the nature of the grafts, it can be divided into tissue grafting and cellular grafting ( 22 ). Tissue grafting, such as suction blister grafting, costs about 100 CNY per square centimetre in China, and is simple to perform, but it is generally suitable for small areas and skin lesions in specific areas ( 23 ). In addition, progress has been made in cellular grafting in recent years.…”

Management of the refractory vitiligo patient: current therapeutic strategies and future options

“…Although ABEM is expensive, it is relatively convenient and provides a larger transplanting area. In a comparative study involving 75 patients, SBEG had better re-pigmentation than ABEM, while ABEM allowed for improved treatment satisfaction with a better operative experience ( 36 ).…”