Using autologous hair filaments to suture facial wounds yielded good edge coaptation, enhanced healing and excellent aesthetic outcomes, according to a recent 54-patient study in Eplasty.
Lead author Mohammed Al azrak, M.D., chief plastic surgeon at Fayoum General Hospital in Egypt, began using the technique more than 8 years ago, as a surgical resident at a low-equipped rural hospital.
“During my service in the emergency department, at 5 a.m. one morning, I was faced by a 7-year old girl who was injured on her forehead,” Dr. Al azrak tells The Aesthetic Channel. “However, there was no fine suture available in the hospital. Also, it was too early in the day to purchase suitable sutures.”
While contemplating what to do, Dr. Al azrak looked at the injured girl’s long hair. “I told the parents that I would try to use the filaments of hair from their daughter instead of fine sutures,” he says. “I harvested a long durable hair filament from her scalp, then used the needle of an available insulin syringe to produce a suture.”
The wound was closed and the stitches removed 1 week later.
More than 3 months later, he was visited by the parents and their daughter. “At first, I did not recognize the stitched site,” Dr. Al azrak recalls. “Since then, I have applied hair as a suture extensively in various emergency and elective procedures.”
Dr. Al azrak mostly harvests hair filaments from the scalp, as long as the length of the filaments is long enough to make a suture and stitches.
“I have produced very short suture ampoules (5 cm) and very long hair suture ampoules (1 meter),” he says. Micro-instruments are used for wound stitching.
About the Study
All study patients were female (mean age 10.8 years) with traumatic facial wounds (mean wound length 3.6 mm). The injury depth varied from only cutaneous to muscle involvement.
After using hair filaments as suture threads, “the scars were often hardly visible,” Dr. Al azrak says. “In addition, suture marks were not detected and there were no cutaneous reactions.”
The technique is also low cost and suitable for facilities with equipment limitations. “It can be used on the battlefield as well,” Dr. Al azrak says.
Furthermore, Dr. Al azrak has had good results when suturing a mother’s hair to her son or using hair from a nonrelative.
“In a few cases, I have encountered temporary local hyperemia, which subsides in a few days,” Dr. Al azrak says. “But there have been no infected cases, although I do sterilize the hair.”
To increase the safety of using hair filaments, Dr. Al azrak recommends examining the scalp to exclude diseases and harvesting the more durable long hair filaments.
“My personal impression about suturing by hair is that it is very harmonious with the skin,” Dr. Al azrak says. “I receive great gratification from my patients and their relatives.”