Review of Factors Affecting the Growth and Survival of Follicular Grafts

The document from May 2010 reviewed factors that influence the growth and survival of follicular grafts in hair transplant surgery, noting that inconsistent growth and survival rates are still a challenge. It emphasized the importance of basic hair care practices and discussed the benefits of advanced storage solutions and additives. The review found that robust terminal hair and grouped follicles have better survival rates, and that finasteride and minoxidil can improve hair vigor. It suggested that advanced intracellular balanced solutions may offer benefits for graft survival, especially if graft insertion is delayed beyond 6-8 hours, and that antioxidants in storage solutions could help prevent ischemia-reperfusion injury (IRI) and apoptotic cell death in hair grafts. Enhanced saline solution showed a 98% survival rate for grafts, and various additives were found to have positive effects on hair shaft elongation and vascular endothelial growth factor induction. Platelet-rich plasma (PRP) had mixed results in studies, and chilling grafts showed no significant difference in survival up to 6 hours. Freezing at -20°C resulted in poor survival, and light microscopy was deemed unreliable for assessing graft viability after freezing. The document concluded that while many factors influence graft survival, the optimal storage solution and effective additives are key for improving outcomes, and all issues in the hair transplantation procedure must be addressed for better graft survival.