Role of hair follicle transplantation in treatment of chronic ulcers: a systematic review | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Articles in Press, Accepted Manuscript, Available Online from 26 April 2025 | ||||
| Document Type: Review Article | ||||
| DOI: 10.21608/ejprs.2025.371293.1418 | ||||
 View on SCiNiTO | ||||
| Author | ||||
Mohamed Elshahidi  
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| Resident, Burns and Plastic Surgery Center, Mansoura University, Mansoura, Egypt | ||||
| Abstract | ||||
| Background With a prevalence rate of 2.21 per 1,000 individuals, patients affected by chronic wounds experience considerable economic, social, and psychological burdens. Moreover, the increasing prevalence of chronic medical conditions may limit the treatment options available for specific patient populations. Standard interventions for individuals suffering from chronic ulcers encompass compression therapy, negative pressure wound therapy, and skin grafting. Recently, multipotent stem cells derived from hair follicles have gained recognition as a feasible alternative for patients for whom conventional care is insufficient. Objective To systematically review the literature on the role of hair follicle transplantation in the treatment of chronic lesions. Materials and methods PubMed, Embase, Web of Science, Cochrane Library, and Scopus were searched from their inception until January 16, 2025. Clinical trials utilizing hair follicular unit transplantation for the treatment of chronic ulcers were included. After screening the titles and abstracts of 9,692 records, ten studies were included in this review. Results A total of 131 cases of various types of chronic ulcers were included, primarily affecting the lower limbs. The mean age of the cases ranged from 37 to 73 years, with a predominance of males. The mean size of the ulcers ranged from 6.72 to 82.49 cm², and the duration of chronicity varied from 6 weeks to 30 years. Sixty-eight percent of the cases reported complete wound healing over a period of 18 to 24 months. Histological examination confirmed the presence of increased remodeling, neovascularization, and the appearance of adnexal structures in the dermis. No significant complications were reported. However, there are concerns regarding the risk of bias in the included records. Conclusion With the need for new modalities for treating chronic ulcers, hair follicle unit transplantation may be a promising alternative for cases in which standard care is not successful. Also, larger and well-designed clinical trials are needed to expand our current understanding of the underlying mechanisms of HFUs' contribution to wound healing. | ||||
| Keywords | ||||
| Hair follicle; Wound; Chronic ulcer; Skin graft | ||||
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