Vitiligo Surgery
In India, vitiligo is considered a social stigma and afflicted patient and his family obstracised, hence it is important for dermatilogist to completely cure the patient. Sometimes patients are not responding to all the possible medical therapies or responding very slowly in this case surgery is necessary.
Indication for surgery : Patients not responding
to adequate trial of medical line of treatment.
Vitiligo lesion should be strictly stable for minimum of two years,
It carried out under local anesthesia consists of thin punch grafts of sizes 1.5,2 or 2.5 mm with minimised cylindrical skin biopsy punches.Pigmented donor site & individually garft them in the appropriate punch out chambers, spaced 5 to 10 mm apart at vitiligo site.
Multiple thin grafts of 2 - 2.5 mm diameter are taken from the donor site by special punches and grafted on to the diseased area. Once the grafts are 'taken up' the patient is advised to take PUVA or PUVA SOL. Repigmentation occurs in 3 - 6 months and good cosmetic result is obtained.
Antibiotics,antiinflammatory drugs taken for seven days.
Exposure to natural sunlight, UVA after the grafts are taken up till repigmentation.
Post punch grafting results of patient with most difficult type of vitiligo, LIP-TIP
vitiligo.
Dressing at the donor site removed after 8-10 days and at the Recipient site,after 24 hours dressing is removed to check, if any graft has shifted. Next dressing after 8-10 days.
Cosmetic tatooing.
Thin thiersch's graft.
Excision and closure.
Suction blister technique.
Miniature punch grafting.
Therapeutic wounding-dermabrasion,laser ablation, LN2 cryosurgery,phenol or TCA applicatiom, needling ect.
Ultra thin grafting.
Grafting of non-cultural epidermal suspension.
Skin cultures, Trypsinized auto graft injection,single hair transplant homologous grafting etc.
