FUT or strip method is still the commonest method of hair transplant practised worldwide although FUE is picking up. FUT is especially common among plastic surgeons in Kolkata and India in general and can be a reliable method of hair transplant in patients as there is minimal donor follicle loss during harvesting unlike the FUE technique which is blind. The disadvantage of the FUT technique is the presence of a linear scar at the back of the head. Therefore, techniques have been implemented to address this scar. Let us look at the closure techniques employed in the FUT donor area.
Many hair transplant surgeons starting early on in their career employ the non-trichophytic closure. This procedure is also employed in cases requiring a wide strip and in those cases where there is insufficient scalp laxity. Basically, in this technique, the wound is closed as it is after harvesting the strip. This produces the widest scar among all techniques.
Upper trichophytic closure
In this technique the upper part of the incision line is trimmed such that the bulge of the follicles lining the upper part as well as the sebaceous glands are not disturbed. The idea is to align the direction of the hair follicles over the upper part of the incision such that they grow through the scar. This technique reduces the scar width.
Lower trichophytic closure
In contrast to the upper part the trichophytic closure is employed in the lower part of the incision in this technique which again helps to decrease the width of the scar.
Combined upper and lower trichophytic closure
In this method both the upper and lower margins of the incision are closed using the trichophytic technique. This produces the best scar among all closure methods but it must be remembered that this technique can be employed only in those patients whose scalp laxity is quite appreciable and there is no tension during closure. Therefore, this cannot be applied in each and every patient.
Trichophytic closure is the norm in hair transplant donor site closure when a FUT technique is being employed. However, this might not be possible in every case for reasons outlined above. Still, surgeons should use this method to reduce donor area scarring as much as possible.