Comparison of Surgical Methods on Resistant Sites in Stable Vitiligo Patients

Summary

Comparing the Efficacy of Three Different Surgical Methods on Resistant Sites in Stable Vitiligo.

Conditions

• Vitiligo

Interventions

PROCEDURE

SUCTION BLISTER EPIDERMAL GRAFTING

1. Preferred donor sites for making blister is lateral aspect of upper thigh. The area is shaved and cleansed with surgical spirit. 2. Blister formation is induced by using suction apparatus. 3. Recipient site is surgically prepared by doing dermabrasion. 4. After formation of blisters, each blister is gently cleansed with normal saline and cut all along its border with curved iris scissors parallel to the skin surface. The roof is everted over the thumb with dermal surface facing upwards and then with the help of blunt end of forceps it is placed on the recipient area. 5. The graft is firmly pressed with sterile moist gauze to remove any underneath serous collection. 6. The pressure dressing is done with double layer framycetin tulle, moist gauze and bandage. 7. Donor area is dressed with dry sterile pads. 8. The part is immobilized and Antibiotics and Analgesic are given till dressing are removed (after 5-7 days).

PROCEDURE

MINI PUNCH GRAFTING

1. Recipient area is prepared first after shaving and cleaning with surgical spirit. 2 % lignocaine with or without adrenalin will be infiltrated as local aneasthetic. 2. The punched out chambers are spaced at a gap of less than 5 mm (preferably 2 - 2.5 mm) from each other. 3. The donor area is either upper lateral portion of thigh or gluteal region. 4. Grafts are placed directly from donor to the recipient area. Care is taken, so that graft edges are not folded, the tissue is not crushed or placed upside down. 5. Hemostasis is achieved by pressing a saline soaked gauze piece over the area. 6. For the recipient area 3 layers of dressing from inside out are : paraffin embedded non adherent sterile gauze, sterile surgipad, and micropore. 7. For the donor area only surgipad and micropore are used. 8. Immobilisation of recipient area is advised along with antibiotics and analgesics till removal of dressing (after 4-7 days).

PROCEDURE

NON CULTURED EPIDERMAL CELL SUSPENSION

1. About one-tenth the size of recipient area is selected as the donor site. 2. Split thickness skin graft is taken under aseptic precautions with the help of a shaving blade held firmly by a straight artery forceps. 3. The area is dressed with Bactigras gauze. 4. Split thickness skin specimen is transferred under aseptic conditions to a container with Normal Saline and transferred to laboratory for preparing suspension. 5. Recipient site is dermabraded under aseptic precautions until tiny pinpoint bleeding spots are seen. 6. Epidermal cell suspension is carefully transferred to a tuberculin syringe. 7. With 18 gauge needle attached to this syringe, suspension is spread evenly on dermabraded recipient site. 8. This is then covered with Collagen dressing, followed by bactigras, guaze and tegaderm dressings from inside to outside. 9. The patient is observed for 2 hours after performing the procedure and given antibiotics and analgesics for 5-7 days till dressing removal.

Sponsors & Collaborators

• Post Graduate Institute of Medical Education and Research, Chandigarh

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2017-07-01

Primary Completion

2018-10-31

Completion

2018-11-30

Countries

• India

Study Locations