Concurrent with resurfacing technology was the suggestion that a narrow band of thermally damaged tissue should be hemostatic and might allow for rapid and bloodless hair transplantation by insertion of thin slits of hair-bearing skin or individual follicular units into slits or holes made by one of these lasers. Although with the CO2 laser a bloodless wound can be produced by either an UltraPulse laser or laser with rapid scanning, the amount of oxygen diffusion through this area and the rapidity of establishment of a vascular supply to the hair matrix was questionable and so, yet another controversy (363-366) began in the mid-1990s.
Walter Unger (367-370), a prominent hair transplant surgeon, first reported his experience in 1994 with the UltraPulse laser. He thought that laser-recipient sites had good hair growth but that it was delayed compared to control cold steel grafts. Fitzpatrick
(371) found that the laser-assisted procedure was 50% faster than control cold steel grafting but healing was slower and graft take was not as good. Ho et al. (372) claimed that slit placement with the UltraPulse laser was 50% faster than cold steel and thought growth in lased slits was good. Grevelink and coworkers (373,374) first reported on the use of a CO2 laser with the Sharplan SilkTouch scanner to develop recipient sites. Smithdeal (375) in 1997 employed the Sharplan scanner with good results and Tsai et al. (376) using a similar scanner said that his patients thought the laser-prepared sites looked more natural and had better density than cold steel sites. Neidel et al. (377) recently reported a single case of Er:YAG laser-assisted transplantation with a good results. A small number of physicians are still promoting laser methodology (366,368,370,372, 376,378) but cold-steel surgery is still the predominant method of graft recipient design (365).
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