Graft storage solutions and why they affect survival
Between extraction and placement, grafts sit in fluid.
Between extraction and placement, grafts sit in fluid. Preservation solutions designed for organ storage outperform plain saline over long periods, but within a well-run session the choice matters far less than keeping the session short and the grafts wet.
What are the two families of graft storage solutions?
The two families are extracellular solutions — normal saline, lactated Ringer's, Plasma-Lyte — which match the fluid outside cells, are cheap and near-universal, though saline is formulated for irrigation rather than preservation. Intracellular preservation solutions, such as HypoThermosol, instead match the environment inside cells as energy-dependent pumps fail, with added ATP as an energy substrate.
How much do advanced graft storage solutions actually help?
Research shows advanced storage solutions offer a modest benefit within the first six to eight hours, with greater advantage only once grafts remain out of the body beyond that window, which a well-run procedure should never reach. Storing grafts in premium solution for nine hours has not solved a problem; it has created one.
What matters more than the storage solution itself for graft survival?
What matters more is session length, which determines how long the first grafts wait; team size, which determines how fast grafts move from extraction to placement; keeping grafts submerged, since dehydration acts within minutes rather than hours; and gentle handling, because trauma to the bulge region is more damaging than trauma to the bulb.
- Session length, which determines how long the first grafts wait
- Team size, which determines how fast grafts move from extraction to placement
- Keeping grafts submerged, since dehydration acts within minutes rather than hours
- Gentle handling, because bulge-region trauma is more damaging than bulb trauma
What should patients ask a clinic about graft storage?
Before booking, worthwhile questions include which holding solution the clinic uses for grafts, what out-of-body time you should expect for the very first grafts extracted during your session, and specifically how many people on the team will be placing grafts throughout the procedure.
- What holding solution do you use?
- What is the expected out-of-body time for the first grafts?
- How many people place grafts?
Our article on out-of-body time and graft survival covers the evidence in full.
Sources
- Parsley WM, Perez-Meza D. Review of factors affecting the growth and survival of follicular grafts. Journal of Cutaneous and Aesthetic Surgery, 2010;3(2). jcasonline.com
This article summarises published research and standard clinical practice. It is general educational information, not medical advice, and it does not replace the instructions your own surgical team gives you. Where their guidance differs from anything here, follow theirs.
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