Are grafts secure by day 9 so I can remove the crusts?
About the 9 days, I put a bit pressure while doing the circular motion and there was no blood. Is this a safe time to have taken off the crusts?
9 days is safe, according to our article, which states: “Since crust formation only occurs in the 1-2 day post-op period, while there is still active exudate,
vigorous irrigation during this period should be able to eliminate surface crusting while allowing the coagulum that formed around the graft, to hold it firmly in place. To this end, these authors are currently instructing patients to take very frequent showers, as often as every three hours the day following surgery. As anticipated, this one day treatment seems to significantly decrease the amount of crusting formed. Once patients pass through this “exudative” period, crusts no longer develop and they are free to shampoo and shower at their regular schedule. Since there is no crusting, patients can at least theoretically resume their normal hair care activities such as shampooing, brushing, and styling by day 6 or, if one wants to be more cautious, at one week.” I am still concerned about some patients whose entire recipient area is covered with a thick wall of crusts. In these patients, I would add an additional 3 days before being aggressive at removing the crusts with good washing techniques.
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