The technique of follicular unit extraction (FUE) is often performed utilizing punches fixed on a straight handle that requires an alternate rotating movement by the thumb and index finger during skin penetration. During this step, it is difficult to maintain the handle perfectly positioned in the proper axis aligned with the follicular unit. The consequence is that the graft is often transected in its depth. Moreover, grafts that get blocked inside the punch require removal with very thin forceps, a step that is tedious and time consuming.
A new surgical handle developed by Mr. Boudjema rotates the punch in alternating directions during skin penetration with an axial backward and forward movement of the hand. The instrument also provides a means for easy and rapid evacuation of any grafts that are blocked inside the punch. It consists of a piston taking the form of a screw rotating axially inside a body or hand piece held by the hand. The head of the instrument adapts to punches of different sizes and houses a moving piece for rapid graft ejection (See Photo above).
How the Instrument Works
At rest position, the handle is grasped and the punch is placed against the skin in the axis of the follicular unit. The handle is then pushed forward resulting in the combination of rotation and penetration of the punch perfectly positioned around the axis of the graft. The instrument is pulled back and removed from the skin ready to cut the next graft. The grafts are then grasped with forceps for removal from the skin. Sometimes, a graft may be blocked inside the punch during the withdrawal of the instrument. It is possible to easily dislodge it from the punch by using a finger to move forward the ejection rod located inside the tip of the instrument (See Photo below).
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The head of the instrument showing how a blocked graft can be evacuated from the punch by moving the ejection piece forward. |
In his personal practice, Dr. Boudjema feels this new device is easy to use, accurate, and saves time compared to conventional handles. We consider it could be added to the existing tools available for the FUE technique.