Unit Patches
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 Zombie Eradication and Disposal Unit Patch Desert Velcro By Doomsday Apparel $7.00 Time Remaining: 4d 22h 11m Buy It Now for only: $7.00 |
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 pn5 RAYS MILITARY UNIT PATCH PENNY AUCTIONS trying to clear some inventory $1.92 (2 Bids) Time Remaining: 7h 37m |
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 ACU DCU 4th INFANTRY DIVISION UNIT PATCH un38 $1.99 Time Remaining: 7h 37m |
 800th MILITARY POLICE BRIGADE AR NY UNIONDALE UNIT PATCH un118 $2.00 (2 Bids) Time Remaining: 7h 37m |
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 MILSPEC 38th INFANTRY DIVISION UNIT PATCH un21 $1.75 Time Remaining: 7h 37m |
 63rd MEDICAL BRIGADE UNIT PATCH un55 $1.75 (1 Bid) Time Remaining: 7h 37m |
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 pn7 82nd AIRBORNE DIVISION RAYS MILITARY UNIT PATCH PENNY AUCTIONS $2.00 (3 Bids) Time Remaining: 7h 37m |
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 AFGHANISTAN NATO ISAF AFGHAN UNIT FLAG VELCRO PATCH $9.99 Time Remaining: 22d 13h 27m Buy It Now for only: $9.99 |
 3 for 1 PRICE 3 MILITARY UNIFORM INSIGNIA UNIT PATCH $2.25 (1 Bid) Time Remaining: 7h 37m |
 TAN 42nd INFANTRY DIVISION UNIT PATCH un57 $0.99 Time Remaining: 7h 37m |
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 TAN 2nd MARINE DIVISION UNIT PATCH un92 $1.85 (1 Bid) Time Remaining: 7h 37m |
 used 77th SUSTAINMENT BRIGADE milspec army issue UNIT PATCH un18 $2.25 Time Remaining: 7h 44m |
 US United States Military Woodland Green Black Flag Iron On Sew On Patch BDU $1.99 Time Remaining: 2d 3h 58m Buy It Now for only: $1.99 |
 TAN 96th ARCOM UNIT PATCH un59 $1.99 Time Remaining: 7h 44m |
 197th FIRE BRIGADE UNIT PATCH un40 $1.75 Time Remaining: 7h 44m |
 Urban United States US Shoulder Reverse Flag Patch $1.99 Time Remaining: 20d 8h 33m Buy It Now for only: $1.99 |
 4th INFANTRY DIVISION UNIT PATCH un20 $2.25 Time Remaining: 7h 44m |
 PERSONNEL SUPPORT UNIT PATCH cf24 $4.75 Time Remaining: 7h 44m |
 USA US UNITED STATES AMERICAN FLAG UNIFORM MILSPEC CAMO ACU LIGHT VELCRO PATCH $5.95 Time Remaining: 12d 8h Buy It Now for only: $5.95 |
 I HAVE NO IDEAL WHAT THIS PATCH MEANS UNIT PATCH z1 $3.75 Time Remaining: 7h 44m |
 38th INFANTRY DIVISION UNIT PATCH un28 $1.81 (2 Bids) Time Remaining: 7h 44m |
 US Military USMC Seal of the United States Marine Corps Patch w Velcro $2.50 Time Remaining: 16d 23h 50m Buy It Now for only: $2.50 |
 TAN 7th SIGNAL BRIGADE UNIT PATCH un31 $1.99 Time Remaining: 7h 44m |
 USAF PARARESCUE THAT OTHERS MAY LIVE UNIT PATCH sp12 $7.50 Time Remaining: 7h 44m |
 USA US UNITED STATES AMERICAN FLAG UNIFORM MILSPEC DARK OPS SWAT VELCRO PATCH $5.95 Time Remaining: 10h 28m Buy It Now for only: $5.95 |
 FAITH FELLOWSHIP FUN FITNESS CONQUERORS CLUB 2008 UNIT PATCH sp2 $3.75 Time Remaining: 7h 44m |
 TAN 1st PERSONNEL COMMAND UNIT PATCH un30 $1.99 Time Remaining: 7h 44m |
 REVERSE United States Shoulder Arm Flag Patch $1.99 Time Remaining: 12d 3h 37m Buy It Now for only: $1.99 |
 AIRCRAFT INTEGRATED MAINTENANCE OPERATIONS DCMA UNIT PATCH r14 $3.75 Time Remaining: 7h 44m |
 UNKNOWN UNIT CROSSED SABERS HELMET PATCH z4 $4.35 Time Remaining: 7h 44m |
 US Military Seal of the United States Navy Embroidery Applique Patch w Velcro $2.50 Time Remaining: 16d 23h 56m Buy It Now for only: $2.50 |
 TAN color 81st ARCOM UNIT PATCH un88 $2.25 Time Remaining: 7h 44m |
 UNKNOWN UNIT PATCH U58 $4.35 Time Remaining: 7h 44m |
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Instrumentation For Three-Step Follicular Unit Extraction (Fue)
Objective
The purpose of this study is to describe a simple instrument that can be used in the blunt dissection phase (second step) of the three-step Follicular Unit Extraction technique and to measure its effectiveness in a controlled study.
Materials and Methods
In patients undergoing hair transplantation, the hair in a 2x4 cm patch in the mid-portion of the donor area was clipped to approximately 1-mm in length and anesthetized. Ten follicular units were extracted from one half of the patch using two-step FUE and ten follicular units were extracted from the other half of the patch using the three-step technique. The two step technique was performed using a 1-mm Miltex punch and fine rat-tooth forceps. In the three step technique, a 1-mm Miltex punch was used to score the skin, a thin cylindrical stainless steel tube was used for the blunt dissection and then fine rat-tooth forceps were used for the extraction. The sides were alternated on different patients. After extraction, each graft was examined under a stereo-microscope and the following information was recorded: 1) hair characteristics; color, wave, and thickness, 2) anticipated yield - the number of hairs visible with the stereo-microscope on the surface of the extracted graft, 3) actual yield - the number of intact follicles in the follicular unit visible under the stereo-microscope. Intact hair yields and graft yields were calculated for the two techniques and compared.
Discussion and Results
In the two-step follicular unit extraction technique, proposed by Rassman and Bernstein, there was an attempt to "separate follicular units from the surrounding tissue down to the level of the mid dermis." The rational was that because of the anatomic divergence of individual follicles as the follicular unit entered the fat, a punch that neatly encompassed a follicular unit on the surface would amputate the splayed bulbs as it cut through the deeper tissues and result in unacceptable rates of transection.
To circumvent the problem of "follicular unit splay," they considered Inaba?s technique of removing hair from the donor area with a punch that was used to cut only part of the way down the follicle. The depth of the traditional punch (used in older hair transplant techniques) was difficult to control, however, and transection resulted in many cases. The FOX test was able to screen out the patients who were most likely to be subject to excessive transection and thus improve patient selection, but it did not improve the quality of the grafts.
The three-step FUE technique of Harris overcomes the limitation of the original technique, as the blunt tipped instrument is advanced into the dermis, splayed follicles are gathered together avoiding transection. In effect, Harris? dull-punch technique allows a full realization of the "extraction concept." One untoward result of the three-step technique is a possible higher incidence of buried grafts. It also adds an additional step to an already tedious hair restoration process.
There are many possible permutations of blunt instrument design. Possibly the most straightforward is to use a cylindrical instrument whose walls are thin enough to dissect though dermal connective tissue with a simple rotating movement, yet thick enough so that the advancing edge avoids follicular transection. The instrument design used in the current study will be presented. The current study confirms the advantage of the three-step procedure over the standard method of follicular unit extraction.
Conclusion
The three-step FUE technique proposed by Harris offers significant improvement over the two-step technique. The main advantage of the three-step technique for hair transplantation is that it minimizes follicular transection. The main disadvantages are the logistics of the extra-step and the increased incidence of buried grafts. A new type of blunt instrumentation is described in this study. The ideal tool design that will minimize both transection and the possibility of buried grafts still needs to be determined.
About the Author
Dr. Bernstein is recognized worldwide for pioneering Follicular Unit Hair Transplantation. Dr. Bernstein’s hair restoration center in Manhattan is devoted to the treatment of hair loss using his state-of-the-art hair restoration techniques. To read more publications on hair transplants, visit http://www.bernsteinmedical.com/.
K-Unit and Patches sliding