Abstract
Gaunthier and Surleve-Bazeille1 used a noncultured autologous melanocyte rich epidermal cell /basal layer cell suspension in 1989. They injected cell suspension into blisters produced with liquid nitrogen. The scalp was chosen as the donor area. This technique was refined by Olsson and Juhlin2 and further by Mulekar. 3 According to a study conducted by Mulekar,3 for the patients with a recipient area of >100 cm2, a donor area of one-tenth of the recipient area was marked on the lateral aspect of the gluteal region. The area was then anesthetized with 1% Lignocaine. Skin was stretched and a very superficial sample of 200 mm in thickness (as estimated by a biopsy sample by a pathologist) was taken with Silver's Skin grafting knife. The thickness was adjusted by closing the screws at both ends. The superficial wound was then covered with sterile Vaseline gauze. The skin sample was immersed in trypsin solution, the epidermis separated from the dermis, and after some additional steps, a cellular suspension of kerati-nocytes and melanocytes was obtained, which was transplanted on the denuded recipient site. The recipient area was abraded down to the dermo-epidermal junction with a high-speed dermabrader fit-ted with a diamond fraise wheel. The ideal level was achieved when pinpoint bleeding spots appeared. The denuded area was covered with gauze pieces moistened with normal saline. Cell suspension was applied evenly on the denuded area and covered with collagen, which helps the transplanted cells to remain in place and provides an optimum environment for cellular growth and vascularization. This was then covered with sterile gauze pieces moistened with DMEM F12 medium. The treated area appeared bright pink immediately after removal of the dressing. The earliest pigmentation was noticed 3 weeks post surgery. Many patients showed hyperpigmentation, which gradually blended with the surrounding skin over 6–8 months. The donor area healed rapidly and soon became indistinguishable from the surrounding skin. Occasionally, the donor area healed with hyperpigmentation.
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(2009). Cellular Grafts. In: Microskin Grafting for Vitiligo. Springer, London. https://doi.org/10.1007/978-1-84882-605-2_8
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DOI: https://doi.org/10.1007/978-1-84882-605-2_8
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