Four Compartment Method As an Efficacious and Simplified Technique for Autologous Non-cultured Epidermal Cell Suspension Preparation in Vitiligo Surgery: A Randomized, Active-controlled Study

Background: Autologous non-cultured epidermal cell suspension (NCES) is a successful surgical method for repigmentation of stable, refractory vitiligo. The need for laboratory equipment and expertise restricts its use to only a few research centres; hence, there is a requisite to simplify the technique of NCES preparation.

Objectives: To evaluate the efficacy of NCES prepared by four compartment (4C) method compared to the laboratory-based method (lab-NCES).

Methods: Anatomically based matched lesions (41 pairs) in 30 stable vitiligo patients were randomized to receive NCES prepared by 4C method or lab-NCES. Each patient was evaluated at 4, 8, 16 weeks after surgery by a blinded observer with regard to extent of repigmentation, colour match, patient global assessment (PGA) and pattern of repigmentation.

Results: Repigmentation outcome in 4C method as compared to lab-NCES was as follows: excellent (≥90%) repigmentation: 34% vs. 37%, P = 1.000, good (≥75%) repigmentation: 68% vs. 71%, P = 1.000; colour match: 59% vs. 54%, P = 0.794, patient satisfaction based on PGA score - 23.02 vs. 23.39 (P = 0.210) and major pattern of repigmentation (diffuse) - 76% vs. 71% (P = 0.618).

Limitations: Short follow-up period of 16 weeks.

Conclusion: Four compartment method is a simple and effective technique for vitiligo surgery in routine clinical practice.