INTRODUCTION
Surgeons performing hair restoration procedures routinely create thousands of micro incisions in the donor and recipient areas. This procedure creates a very unique set of challenges. Intraoperative bleeding control can become an issue. No spray solutions have shown a benefit regarding hemostasis. Hypochlorous acid (HOCl) may be the exception. Postoperative complications in hair restoration surgery are infrequent, but include infection, swelling, bleeding, and, rarely, tissue necrosis. There are many types of topical products available for postoperative wound care but few have been evaluated in clinical trials.1 There is scant evidence that any one topical agent speeds healing of surgical wounds by secondary intention more than another agent.1 Compelling evidence exists in the literature that demonstrates that topical HOCl represents an ideal agent of choice for postoperative care in hair restoration surgery patients.7-10
Stabilized Hypochlorous
HOCl is a naturally occurring molecule whose mechanism of action is achieved through white blood cells. Specifically, neutrophils augment host immunity when they release HOCl to aid in the destruction of pathogenic organisms such as bacteria, fungi, and yeast. Unlike antibiotics, when used topically as a stabilized formula, there is no evidence microbial resistance will emerge.8
Antimicrobial Properties
Studies show HOCl exhibits broad-spectrum antimicrobial properties at concentrations of 0.1 to 2.8 micrograms/mL.11 The literature regarding its efficacy in the reduction of Staph aureus is abundant.21-25 A closer look at these various studies (which were performed with HOCl gels, sprays, and solutions) reveals that topical HOCl is impacted by both pH and formulation stability.11,12 Degradation and instability issues of the HOCl
