Dr Lam's Hair Restoration Forum

[ravimanohar]

Dear Dr.Lam
1. In which medium ,you store the grafts
2.Does PRP increases grafts survival

Please let me know your expert opinion.

[dr. lam]

i store the grafts in chilled normal saline mixed with PRP and Acell. i do not know if PRP impacts graft survival but because i believe it can i now soak my grafts in PRP and Acell.

[ravimanohar]

Dear Dr
May i details of the PRP and Acell.How you do it?You use PRP on donor and recepient area also?
In what concentration you mix PRP and acell in Normal saline?

[dr. lam]

currently, my formula is 100 mg of ACell mixed with non-activated PRP about 3 cc mixed into the storage media of normal saline. I also inject activated PRP with thrombin into the donor wound along with straight PRP with ACell in the donor wound. Additional PRP and ACell goes into the recipient site before sites are made and additional activated PRP is placed topically at the end of the case on the recipient area.

[ravimanohar]

Dear Dr
In How much of qunatity of normal saline you mix PRP and acell?
2.How you make PRP and acell?
3.What is activated PRP ,straight and nonactivated PRP?
4.How much quanity of PRP is injected in recepient site?
5.Why you inject thrombin into donor area?
6.Role of Acell in Graft survival?
7.Does PRP has effect on growth of vellus hair/thin hairs?Do you do it?

[dr. lam]

In How much of quantity of normal saline you mix PRP and a cell?
as much normal saline as it takes to keep the grafts moist.
2.How you make PRP and a cell?
acell is a powder or a solid strip. i use the powder form of a cell and mix it with Cytomedix brand of PRP. PRP as you probably know is blood taken from the patient immediately before surgery and then centrifuged.
3.What is activated PRP ,straight and nonactivated PRP?
activated is used with thrombin that may have healing properties and growth properties and i use it when i don't mix with a cell.
4.How much quanity of PRP is injected in recepient site?
typically 6 to 9 cc.
5.Why you inject thrombin into donor area?
as an added bonus to help with healing.
6.Role of Acell in Graft survival?
don't know but hopefully early non-rigorous studies have shown that it may help with improved graft survival. that is why i use it principally.
7.Does PRP has effect on growth of vellus hair/thin hairs?Do you do it? unknown but some anecdotal studies is that it does. i am too early in my use of it to know whether it does or not right now but i am injecting it into areas where i do not transplant to see whether it does or not.

[ravimanohar]

Thanks for your reply
In how much concentration PRP is used to store grafts.I mean in 500 ml of Normal saline-How much cc of PRP is added?

[dr. lam]

about 50 cc of saline. however, the 3 cc of PRP/ACell that is placed is placed directly onto the tissue within a fold of telfa so it is truly adherent to the grafts.

[ravimanohar]

Thanks.You mix 3cc of PRP in 50cc of saline?Please let me know

[dr. lam]

no, i don't do exactly that. i have all the grafts folded into tiny packets of Telfa and all of that is soaking in a sea of saline. after all the grafts are dissected, i place the 3 cc of PRP and Acell directly onto the grafts within the Telfa packs so they do not become diluted.
s.

[ravimanohar]

thanks for the reply
how much grafts can be soaked with 3 cc of PRP ?

[dr. lam]

As many as I have. It is not that scientific.

[ravimanohar]

thanks .

1.May i know the causes of almost complete failure to take up grafts.

2.What is the ideal time to plan for 2nd transplant in case of faliure of HT?

3.How much percentage of grafts survival be incresed with use of PRP in HT?

4.Recommended Interval between sitting and no of sitting of PRP treatmenmt for thinning hairs?
5.Your view on stem cell therapy for thinning hairs

[dr. lam]

1.May i know the causes of almost complete failure to take up grafts.
could be many things. bad technique or poor health of the scalp to take up the grafts or you are too early to tell. if you have not waited 18 months at least to see if things are improving you should probably do so. i have seen late growth when things looked like it would not grow early. although rare, i just did a gentleman's second round who did not have substantive growth for 18 months.

2.What is the ideal time to plan for 2nd transplant in case of faliure of HT?
see above.

3.How much percentage of grafts survival be incresed with use of PRP in HT?
hard to say. everyone is different. the point of the PRP is not to replace good technique but to supplement it.

4.Recommended Interval between sitting and no of sitting of PRP treatmenmt for thinning hairs?
i don't understand. i use the PRP during the procedure. i have not used PRP as an isolated treatment yet.

5.Your view on stem cell therapy for thinning hairs
verdict is still out. still too early to know if it works.
best,
s.

[ravimanohar]

thanks for the reply.
How much cc of PRP you make for whole HT procedure.