The donor reserve is the area at the back of the scalp with the baldness resistant permanent hair that the strip of hair is removed from. The area is determined in the initial consultations, with hair loss prediction tests.
The ideal candidate is required to have a flexible scalp to fight against scarring and tension as the wound opening is closed and sutures after the excision of the skin strip.
About FUT Donor Scarring and What Is Done To Control It
The donor scar with the strip excision being unavoidable, gives rise to the FUE procedure with which the scars are very minimal, and soon fade of to be totally undetectable. Whereas, the positive potentials of FUT strip excision still reserves to be a considerable option for ideal candidates, in terms of yielding large number of hair grafts with lesser risk of damaging them while dissection; which is at great risk with FUE procedure.
The scars can often be as wide that top layers of hair cannot totally hide them according to the plan, which could be very unsightly with thin donor zones. Especially if the patient has a thin hair density in the donor area, or wishes to crop their hair short. Other risks include effluvium around the donor scar, in further widening it.
Innovation in incision and excision of the skin strip as well as the closing and suturing of the donor wound have largely succeeded in controlling the scarring and achieve aesthetically pleasing camouflage of the donor scar.
The placement of the donor incision is usually at the center of the permanent donor zone, above or immediately below the occipital protuberance. The dimension on the skin strip depends on the amount of hair grafts required.
Single blade skin incision technique replaces the outdated techniques of multiple strip excision and serrated island. The single blade incision reduces the scarring risks. The use of local tumescent anaesthesia helps preparing the tissues with stiffness and making the incision precise and fine.
The height and width of the skin strip is determined with the factors of donor demand, donor supply and the scalp laxity. For a full frontal coverage, and a donor demand of more than 1,800grafts or up to 3,000 hair grafts, the skin dimensions are approximately 20cms in length 2-3cms in height. The actual dimensions vary person to person.
Absorbable sutures on the other hand do not require any further cutting them and the patient is good to go. But the sutures often tangle the hairs in their way often losing them to be used as hair grafts, if ever needed in the future.