Battle of the punches: Comparison of transection rates of different punches during FUE

Abstract

Objectives To know the transection rate using three different kinds of punches of the same size (0.9 mm). Materials and methods The study was conducted in 10 patients undergoing FUE. Informed consent was obtained from all the patients. In each patient, five areas of 1 cm2 were selected in three rows (each row having five areas of 1 cm2). For each row, one kind of punch (sharp, serrated, and blunt) was used. The rows were selected randomly (single‐blind). The machine was set at a constant speed of 1200‐1500 g. The grafts were harvested with the patient in lying position, the surgeon sitting on head side, and the harvesting started from the right side of the patient to left side. For each box, the FUs and hair were calculated. The harvested FUs were checked under microscope. Any transection (complete or incomplete) was calculated. All the data were collected and analyzed. Results The total hair yield was maximum with blunt punch (268.4) followed by serrated (247.2) and sharp (207.6). Similarly, the maximum FU yield was 155 using serrated punch followed by 154.4 by blunt and 147.2 in sharp punch. The hair:FUs was highest in blunt punch (1:1.738) vs serrated punch (1:1.595) vs sharp punch (1:1.410). The transection rate was highest with sharp punch (23.9%) followed by serrated (18.8%) and blunt punch (14.5%). Conclusion The graft:hair ratio was maximum using blunt punch. Sharp punch resulted in maximum transection rate with lowest graft:hair ratio.

The Battle begins: Is strip surgery really necessary?

“…In the previous studies conducted in patients undergoing FUE, result in 30%-50% decrease in donor hair density. 18,19 Moreover, FUE changes the distribution of hair, removing the FUs with more hair, leaving FUs with lesser hair (cherry-picking).…”

The first comprehensive classification of hair transection: A step forward

“…Therefore, many studies mention transection rate without specifying the details of the transection. [4][5][6] If the current terminology is changed to "hair transection rate," the confusion will be resolved. Secondly, there is no classification found in literature about transection itself.…”

“…Two follicles/hairs transected in a 4‐hair graft means one graft transection and two follicle transection which creates confusion in documentation. Therefore, many studies mention transection rate without specifying the details of the transection 4‐6 . If the current terminology is changed to “hair transection rate,” the confusion will be resolved.…”

Optimal choice of punch size for follicular unit excision: A comparative study of 153 Asian patients

“…1 The properties of FUE punches have a significant impact on the success of the procedure. [2][3][4][5] Here, we evaluated three objective outcomes (the characteristics of harvested grafts, wound formation, and the incidence of complications at the donor site) in patients who underwent FUE, according to the diameter of different-sized punches.…”