This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.
This debate as to whether or not a hair transplant surgeon should do hair transplant preoperative blood testing has been going on for years and is probably pretty evenly divided in numbers as to supporters for the two opposite opinions.
First of all, the main two conditions that are being checked for by the doctors who do test are HIV and Hepatitis C. Others will check a blood count, clotting studies, chemistry studies (liver, kidney function, etc). One advantage of having this information on the hair transplant patient’s chart before hair restoration surgery is that, should the hair transplant doctor or one of his assistants be stuck by a bloody sharp during the surgery, immediate measures can be taken to minimize the chance of later serious infection for that person. There are anti-HIV drugs that can be started quickly for instance. If one has to wait for the hair transplant patient’s blood tests to come back, there is a slight delay. One weakness to this strategy is that the blood tests do not become positive sometimes for a few months from the time a patient might be come infected, so that a hair transplant surgical team could conceivably relax their way of doing things with a “negative” HIV and Hepatitus C test, and yet still be vulnerable to becoming infected.
Our own hair transplant clinic happens to be one of the ones that does not require blood tests, except in the case of female hair loss patients, in whom I want to make sure that some appropriate blood work has been done in the previous two years to rule out thyroid, low iron, and possible hormonal causes for balding. Most hair restoration physicians, like myself, who don’t routinely obtain blood work, perform each hair transplant surgery as if the patient actually was positive for one of these infections. (Obviously, the hair restoration surgeons who do test pretty much do this also, I should add.) We never have two hands moving at the same time over the head when a sharp is being used. We keep all open sharps off the surgical tray except as urgently needed at that time and with the sharp ends protected up against or under a covering object so that a sweep of the hand could not encounter the sharp edge or point. All gauze is kept off the tray, as it can cover a sharp. A large sharps throwaway red bin is directly behind me in which I immediately throw any sharp I am done using. Eye, nose, mouth, and skin coverage are also an important part of these precautions, as blood or bloody fluid can spray at times during the hair transplant procedure. I should add that in our consent form the hair transplant patient agrees to have his blood drawn should an accidental stick occur.
Both positions have their merits. I happen to have a smaller practice in which I am on top of every detail and pretty much direct how each maneuver of a sharp is handled, so I feel I have control of keeping unnecessary sticks to an absolute rarity. If I was the director of a larger hair restoration clinic with several hair transplant doctors working for me and a large number of assistants, I think I would feel a greater “corporate” responsibility for all of these people, whom I wasn’t personally supervising every minute, and also would feel a greater medical-legal threat to this larger entity, and I too would probably test each hair transplant patient to protect myself and them, both from a health standpoint and from a medical-legal one.
As I mentioned before, because even a “negative” hair transplant patient could be infected, I feel most comfortable in my sized practice not testing and using universal precautions during each case as if the hair restoration patient was infected. It goes without saying that, if during the initial consultation I have any doubts as to the patient’s health status, I will always refer him back to his own physician for evaluation or send for his records to document that he is healthy.
Mike Beehner, M.D.
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