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The cause of the white dot devil. (Hair Transplant)

posted by marco, U.K, 01.06.2007, 21:20
(edited by marco on 02.06.2007, 05:29)

ť I was also under the impression that primary intention was when an
ť incision healed with no closure (suture, staples, etc.) and secondary
ť intention was healing through some mechanical means. What is the official
ť medical/surgical definition?

I spent several years researching an enzyme called factor XIII and tissue factor so this is an area of some interest to me although it was a LONG time ago.
Primary intention involves the early closure of wound edges. Even if there is some tissue removal this can be bought about by clot retraction or smooth muscle contraction or surgically. Of cause if there is a large tissue loss then the edges of a wound cannot be bought together due to the limitations of skin elasticity (I have just edited to add that healing by primary intention demands that the tissue removal is small which is obvious from the explaination above. for instance the a strip wound is never going to come together without intervention but FUEs are comparitively tiny although the counter forces are still likely to be high if the total tissue removed in a surgery is high)). The upshot is that in primary intention damaged cells are less exposed to the interstitial surrounding fluid. This reduces the effect of things such as tissue factor that the cells release. If the wound is left open then the release of tissue factor as well as other molecules results in a greater degree of macrophage and fibroblast infiltration, tissue breakdown by colagenases and elastases larger scabs, tissue remodelling and scar tissue formation and this is termed secondary or tertiary intention.

Additionally and to bring up an older argument, it seems to me (although it is conjecture) that if a tumescent introduction of fluid (saline adrenalin or anything else) is used to blow up the tissue subdermally then this may stretch the dermis allowing more grafts to be placed but if the fluid does not drain at a reasonable rate then the wound is less likely to close by primary intention . This is very different to the effect of adrenalin in the dermis which has more complex effects on swelling and inflammation and exudation of interstitial fluid. It is the difference between blowing up the melon from inside and influencing the expansion of the skin of a melon. This second area remains a little confusing to me in the context of HT but remains an open issue for me at least.

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Complete thread:

GHI Patient - 3244 FUE 11 Months After - GHI, 30.05.2007, 16:05 (Hair Transplant)
- GHI Patient - 3244 FUE 11 Months After - damon, 30.05.2007, 16:57
  - GHI Patient - 3244 FUE 11 Months After - marco, 30.05.2007, 19:40
    - GHI Patient - 3244 FUE 11 Months After - notanewbiee, 30.05.2007, 22:56
      - GHI Patient - 3244 FUE 11 Months After - marco, 31.05.2007, 11:57
        GHI Patient - 3244 FUE 11 Months After - GHI, 31.05.2007, 19:32
        GHI Patient - 3244 FUE 11 Months After - marco, 01.06.2007, 04:17
        GHI Patient - 3244 FUE 11 Months After - GHI, 01.06.2007, 11:28
        The cause of the white dot devil. - marco, 01.06.2007, 13:33
        The cause of the white dot devil. - FIT2Btied, 01.06.2007, 15:05
        The cause of the white dot devil. - damon, 01.06.2007, 17:59
        The cause of the white dot devil. - Duck, 01.06.2007, 18:28
        The cause of the white dot devil. - damon, 03.06.2007, 18:28
        The cause of the white dot devil. - Jessica, 01.06.2007, 18:54
        The cause of the white dot devil. - marco, 01.06.2007, 21:20
        The cause of the white dot devil. - FIT2Btied, 04.06.2007, 16:30
        The cause of the white dot devil. - FIT2Btied, 04.06.2007, 16:47
        The cause of the white dot devil. - Jessica, 04.06.2007, 17:07