An Algorithmic Approach for Reconstruction of Burn Alopecia

Between 1995 and 2007, a study involving 83 patients who underwent reconstructive surgery for burn alopecia was conducted, leading to the development of an algorithm for choosing the appropriate treatment based on the size, scar quality, and location of the alopecia. The study utilized hair grafting for small areas with good-quality scars, scalp reduction for small to medium areas with good or moderate scar quality, scalp extension for medium areas with moderate scar quality, and scalp expansion for large areas with poor scar quality. Complications were reported in 33.7% of patients, mainly due to the implants used in scalp extension and expansion. The study concluded that the choice of reconstructive method should be customized to the specific characteristics of the burn alopecia, with hair grafting and scalp reduction recommended for smaller, high-quality scars, and scalp extension and expansion for larger, lower-quality scars, despite the higher risk of complications with the latter methods.