Battle of the punches: Comparison of transection rates of different punches during FUE.

Abstract

To know the transection rate using three different kinds of punches of the same size (0.9mm). The study was conducted in 10 patients undergoing FUE. Informed consent was obtained from all the patients. In each patient, five areas of 1cm2 were selected in three rows (each row having five areas of 1cm2 ). For each row, one kind of punch (sharp, serrated, and blunt) was used. The rows were selected randomly (single-blind). The machine was set at a constant speed of 1200-1500 g. The grafts were harvested with the patient in lying position, the surgeon sitting on head side, and the harvesting started from the right side of the patient to left side. For each box, the FUs and hair were calculated. The harvested FUs were checked under microscope. Any transection (complete or incomplete) was calculated. All the data were collected and analyzed. The total hair yield was maximum with blunt punch (268.4) followed by serrated (247.2) and sharp (207.6). Similarly, the maximum FU yield was 155 using serrated punch followed by 154.4 by blunt and 147.2 in sharp punch. The hair:FUs was highest in blunt punch (1:1.738) vs serrated punch (1:1.595) vs sharp punch (1:1.410). The transection rate was highest with sharp punch (23.9%) followed by serrated (18.8%) and blunt punch (14.5%). The graft:hair ratio was maximum using blunt punch. Sharp punch resulted in maximum transection rate with lowest graft:hair ratio.