ATP (Adenosine triphosphate) is an energy molecule that catalyzes a variety of important cellular reactions in our bodies. The lack of ATP can cause cell damage and eventual cell and tissue death. Because the creation and regulation of ATP requires oxygen, tissues deprived of oxygen often experience ATP loss and become damaged. Because of this, ATP becomes crucial for patients healing from wounds; especially surgical wounds. This has created demand for the use of ATP in post-surgical patients and patients with delayed wound healing. One area where the addition of ATP has been investigated for its healing properties is in hair transplant surgery.
According to experts, the addition of ATP – in liposomal ATP form – to follicular unit grafts while they are stored outside of the body and to the recipient scalp after the grafts sites are made could allow for quicker healing and better hair transplant yields. One physician who has experimented with liposomal ATP and believes it offers a variety of benefits in hair transplantation is Coalition hair restoration surgeon Dr. Jerry Cooley.
According to Dr. Cooley:
Early on I began experimenting with ATP, but I didn’t know whether it was helping and usage was intermittent over the first 6 years. However, after reviewing my results I began to believe ATP usage was a significant factor explaining the positive difference in observed results.
Like many experienced clinics, we go to great lengths to protect our grafts from any trauma. Assuming a perfect graft is placed perfectly into the recipient site, why wouldn’t it grow? I believe the biggest reason is ischemia (lack of oxygen = lack of ATP). Doctors who do other skin grafting will tell you that blood flow (ie oxygen and ATP supply) is the major predictor in follicular unit graft survival.
I’m a dermatologist and in the past, I did a lot of skin cancer surgery which often required skin grafts to close the wounds. If we do a skin graft on to the face (where blood flow is good), it usually takes and survives. If we do a skin graft on the lower leg (where blood flow is much lower), it often sloughs off and merely acts as a biological bandage until new skin is produced to fill the wound. Years ago, I removed a large melanoma from an elderly woman’s lower shin. She had poor circulation and I had every reason to think the skin graft I placed wouldn’t survive. However, I rigged up an IV bag with ATP solution that continually dripped over the graft for several days. The graft completely took and after it healed, the only sign we had ever done a graft was a faint circular scar at the margins. The skin in the graft looked like the surrounding skin, which was a much better than expected result. This is one more piece of evidence in my mind.
Numerous top hair clinics have started trying post-op ATP spray on their patients. I have gotten feedback from many of these on how quickly their patients are healing now. It will take a couple years before these doctors are convinced it is improving survival, but that is the nature of our field. The best way for a doctor to be convinced that ATP is doing something is to use it on their toughest cases (eg. densely packed grafts into areas with low blood flow like scar tissue and areas of previous transplants) and see if their results are better than what they would predict. Some hair transplant surgeons even try to finish an area in one single surgery because they believe survival is lower in previously transplanted areas. Why? You guessed it: lower blood flow = lower oxygen = lower ATP. I believe this and have seen positive results – including less shedding, earlier regrowth, and very high yield.
Most experienced clinics get good growth. If I get less than expected growth in 10% of my cases, then for me, that is too high. I want every case to turn out perfect and every graft to survive. That is why I use post-op ATP.
Blake Bloxham – formerly “Future_HT_Doc”
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