Double syringe blistering by adding a three-way connector for grafting stable vitiligo patches

Abstract

BACKGROUND/AIMS: Blistering and grafting the roof of blisters to either dermabraded or cryoblistered vitiliginous sites are techniques used to correct persistent, medically non-responsive vitiliginous patches in stable vitiligo patients or in those with other leukodermas. METHODS: We used two syringes or a syringe and a cylinder funnel connected by a three-way connector for blister induction. The needle pieces of two syringes are connected by a threeway connector. The piston of the first syringe is removed and applied from the base to the donor site. The piston of the second syringe is withdrawn for 100–200% of the volume of the first-applied syringe, which creates a negative pressure of about 260 to 380 mmHg or -380 to -510 mmHg by intermittently locking the three-way connector, removing the second syringe, pushing back its piston and reinserting it, and then withdrawing again. Finally, the three-way connector is locked and the second syringe is removed. This magnitude of negative pressure is enough for a unilocular blister to develop within 0.5–2 h. The roof of the blister is then removed and applied to dermabraded or previously cryoblistered recipient sites covered only by dry or saline-soaked sterile gauze. RESULTS: Subtotal repigmentation may be seen 10–14 days later after removing the dressing. Total repigmentation may occur 2–3 months later after receiving topical or systemic PUVA therapy. CONCLUSION: Connecting two syringes or a syringe and a cylinder bottle by a three-way connector is a simple and inexpensive device for inducing blister, harvesting epidermal sheets and grafting to the recipient stable vitiliginous patches. (J Dermatol Treat (2000) 11:43–46)