Epidermal grafting. An original technique and its application in achromic and granulating areas

Falabella, Rafael

doi:10.1001/archderm.104.6.592

Cited by 88 publications

(89 citation statements)

References 3 publications

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“…They are held in place for 7 days with nonadherent dressing. This technique was first described by Kistala [49], and was used first to treat leucoderma/vitiligo by Falabella [50,51]. Different custom-made devices, such as an oil rotary vacuum connected to a manometer [52], a manually operated suction unit with transparent plastic cups [53] and disposable syringes attached to a threeway tap with a latex rubber tube and 50 ml syringe [54], are used to produce blisters on the donor and recipient areas.…”

Section: Epidermal Graftingmentioning

confidence: 99%

Surgical management of vitiligo

Mulekar¹

2010

Expert Review of Dermatology

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Vitiligo is a common condition characterized by hypopigmented and/or depigmented spots on the skin, affecting approximately 1-2% of the world population. Until approximately 30 years ago, it was exclusively treated by medical therapies. The most commonly used medical therapies include topical steroids, calcineurin inhibitors and phototherapy. Lesions on the face and neck respond the best to medical therapies, followed by lesions on the proximal extremities and trunk, while those distributed over acral parts of extremities and nonhairy areas, such as the wrist, feet and male genitals, respond poorly. Surgical methods complement medical therapies by providing melanocytes to these refractory lesions, and are indicated for unilateral segmental and clinically stable bilateral vitiligo, refractory to medical treatment. Tissue-grafting methods include minigrafting or punch grafting, epidermal grafting and split thickness grafting. These methods use full-thickness punch grafts, roof of epidermal blisters and shave biopsy samples, respectively, as the source of melanocytes. Cellular grafting includes noncultured and cultured melanocytes/keratinocytes suspensions obtained from trypsinizing the shaved skin biopsy sample as a source of melanocytes. Recent advances over the years have enabled dermatologists to treat extensive areas located on any anatomic site in a single operative session by surgical intervention. The purpose of this review is to describe the selection criteria for the surgical treatment, their utility and limitations in the various types of vitiligo.

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Section: Epidermal Graftingmentioning

confidence: 99%

Surgical management of vitiligo

Mulekar¹

2010

Expert Review of Dermatology

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“…Suction blister grafting is an effective, nonscarring, surgical repigmentation method that has become popular since 1971 when Falabella first described its use in leukoderma. (27) Suction blister grafting is accomplished by suction of viable epidermis from dermis and pigmented epidermis is used for coverage of achromic areas. Essentially, this is a technique of melanocyte transfer.…”

Section: Discussionmentioning

confidence: 99%

Suction Blister Grafting- Still a Useful Modality for Treatment of Resistant and Stable Vitiligo

S¹,

Chittoory²

2017

jemds

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BACKGROUNDVitiligo is a common depigmentation disorder due to absence of functional melanocytes in the affected area. Depending on the type, extent and duration of vitiligo, conventional medical therapies and phototherapy are used. Medical treatment is effective in only 60% -70% of the patients. This has led to the evolution of various surgical modalities to treat recalcitrant stable lesions. The aim of this study was to determine the efficacy of suction blister grafts for treatment of recalcitrant and stable vitiligo. MATERIALS AND METHODSThis study was conducted on 20 patients with stable vitiligo. They included lip vitiligo (6 cases), segmental vitiligo (6 cases) and focal vitiligo (8) that were resistant to conventional medical treatments. Manual suction with 20 cc disposable syringes for blisters at donor site and dermabrasion at recipient site was done. The blister was separated, fixed at recipient site and dressing was done followed by NBUVB thrice a week for 3 months. Repigmentation of lesions was evaluated monthly for 6 months after treatment. Repigmentation rates > 90%, 71% -90%, 51% -70% and < 50% were graded as complete, good, moderate and poor respectively. RESULTSThis study includes 20 patients (10 female and 10 male) with stable vitiligo were evaluated for response following suction blister grafting with thrice weekly post-graft phototherapy. Reponses to treatment after a 6-month followup were 'complete,' 'good' and 'moderate' in 12 (60%), 6 (30%) and 2 (10%) patients respectively and one patient was lost for followup. CONCLUSIONThe grafting procedures in vitiligo are performed for cosmetic purposes. Proper selection of the patient is the most important factor for achieving a good cosmetic result. Stability of the disease process is the most important parameter to achieve a successful outcome. Suction blister grafting gives excellent cosmetic results with minimal chances of scarring at the donor or recipient sites.

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“…Suction blisters were first introduced by Kiistala and Mustakallio in 1964 by using an angiosterrometer [29]. Its use in replacing achromic skin was first reported by Falabella in 1971 [30]. Application of epithelial grafts nowadays is a common treatment technique for vitiligo.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of suction blister epidermal grafting with concomitant phototherapy in vitiligo treatment

Iwanowski

Szlązak

Rustowska

et al. 2018

pdia

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A b s t r a c tIntroduction: There are many surgical methods for vitiligo treatment that have been used for over 30 years. Suction blister epidermal grafting (SBEG) is considered one of the simplest and most effective of them. Aim: To determine how effective suction blister grafts with concomitant phototherapy are in vitiligo treatment. Material and methods: The study was conducted on 10 patients with vitiligo that was resistant to previous treatment including phototherapy in monotherapy. Involvement of affected sites was different for every patient. We used cryotherapy for blistering at the recipient site and an automatic suction device for blistering at the donor site. The blister was separated from the donor site and fixed with dressing to the recipient site. After removing the final dressing (about 7 days after SBEG) patients started phototherapy (6 patients had UVB 311 nm and 4 had PUVA). All patients treated with UVB 311 nm were qualified for treatment in our clinic and the method was chosen according to expert recommendations from the European Dermatology Forum (EDF) Guidelines for Vitiligo where narrowband (NB) UVB is the phototherapy of choice. Three patients who had PUVA therapy were treated with this method in other clinical centers and sent to us only to undergo SBEG. One patient had previously received UVB 311 nm for 3 months, which showed no effects. Repigmentation of lesions was evaluated at 3 and 6 months after the surgical procedure. Results: Ten patients (9 females with a mean age of 36.88 years and 1 man aged 39 years) were enrolled in the study. Nine patients showed progressive repigmentation at 3 and 6 months follow-up with a rate varying from 13 to 76% (mean: 44.5%) and 35 to 100% (mean: 67.5%). One patient showed 5% depigmentation at a visit after 6 months in comparison to the follow-up visit 3 months after SBEG. Conclusions: With this technique, patients who did not respond to the usual treatments showed very good repigmentation over a 6-month follow-up. There were no side effects such as scarring.

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Epidermal grafting. An original technique and its application in achromic and granulating areas

Cited by 88 publications

References 3 publications

Surgical management of vitiligo

Surgical management of vitiligo

Suction Blister Grafting- Still a Useful Modality for Treatment of Resistant and Stable Vitiligo

Efficacy of suction blister epidermal grafting with concomitant phototherapy in vitiligo treatment

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