History
of Melanocyte Transplantation
Melanocyte transplantation done at NOBLE
CLINIC follows the same
guidelines laid out by ( SWEDISH PROCEDURE ). Initially the melanocytes
were harvested from a small part of normal skin, grown in laboratory
& was then transplanted on to the depigmented patch after
dermabrasion. But now a modified procedure is being done where-in
the harvested melanocytes are immediately transplanted on to the
depigmented patch
Methods:
Noble clinic's surgical technique requires no hospitalisation
& is done on an out patient basis at his surgical center.
It requires only local anesthesia, & patient is sent home
immediately after the procedure.
After anaesthetising the normal skin (usually from
thigh/buttocks) a 4cm by 2cm skin is removed, using Silver skin
grafting knife which gives excellent thin grafts containing only
the epidermis. This skin is then incubated in trypsin for one
hour & at the end of one hour, dermis if found is separated
form epidermis.
The epidermis is then divided into small pieces and
mixed with minimum essential media, which keeps the cells alive
till it is transplanted onto the body, centrifuged repeatedly
till a melanocyte pellet is obtained. From a 4x2cm piece of skin,
upto 100square-centimeters of depigmented patches can be treated.
The depigmented patch is anaesthetized (Xylocaine
2% or Emla ointment) & dermabrasion is done using either a
laser or micromotor to remove epidermis, taking care not to injure
the dermis, which can result in scarring.
Once the epidermis has been removed, the melanocyte
suspension is applied over the patch, & wound covered with
a Collagen dressing. This dressing is then removed after 7 days
Results:
» Treated areas remain pink after removal
of dressing.
» Earliest pigmentation is seen with in
3-6 weeks.
» Entire area covers up in 3 to 4 months.
» Excellent cosmetic results are seen in
5-6 months.
» There were no cosmetic side-effects after
the procedure.some patients may require
more than one sitting for 100% pigmentation
Advantages of Melanocyte transplantation
over other surgical procedures
» Day care procedure (no admission is required
irrespective of site of patch)
» Very large areas can be treated.
» Pigmentation appears rapidly within 3-6
weeks.
» Cosmetic results are excellent.
» Difficult areas like fingers, lips can
also be treated(some patients may require two
sittings for complete pigmentation)
» No scarring seen
after surgery.
Results: Success Rates
in
Generalised
Vitiligo(Multiple Patches) |
Segmental
Vitiligo (Usually One Patch) |
82%
(82 out every 100 patients treated developed excellent pigmentation) |
96%
(96 out every 100 patients treated developed excellent pigmentation)
|
