Microsurgical scalp replantation: lessons learned and technical considerations
Case report published in Plast Reconstr Surg Glob Open (2022)
Abstract
Total scalp avulsion is defined as a severe soft-tissue injury which involves the hairy scalp and commonly occurs in women as a result of the entrapment of long hair in high-speed rotating industrial machinery. The first microvascular replantation of an avulsed scalp was described by Miller et al in 1976 when both superficial temporal arteries along with five veins were successfully reanastomosed. Our patient was managed with a vein graft measuring 8 cm in length for reanastomosis of the superficial temporal artery. Furthermore, after successful replantation, we used an expander for aesthetic refinement and achieved an excellent outcome. A scalp replantation should be performed in every possible case. Despite partial skin necrosis, hair growth in the remaining areas is possible. In cases of partial skin necrosis, it is possible to eliminate the hairless areas by implanting an expander and excising the hairless area. A pressure-related ulcer at the occiput is likely due to immobility of the head postoperatively and may be avoided by using a halo fixation device.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Case report of microsurgical scalp replantation using an 8-cm vein graft to reanastomose the superficial temporal artery, with later tissue-expander refinement; occipital pressure ulcers may be avoided by halo fixation.
Context
This case report describes microsurgical scalp replantation in a patient with total scalp avulsion, using an 8 cm vein graft for superficial temporal artery reanastomosis, followed by tissue expander placement for aesthetic refinement. The abstract reviews technical considerations including vein grafting, management of partial necrosis, and use of halo fixation to prevent occipital pressure ulcers. There is no mention of leeches, hirudotherapy, or leech-derived substances. While medicinal leeches are sometimes used in reconstructive microsurgery for venous congestion, this report does not document such application. This article has no direct relevance to leech therapy.
Citation
Reference (Vancouver style)
Wechselberger G, Pumberger P, Schwaiger K, Wimbauer J, Köninger F, Russe E, et al. Microsurgical scalp replantation: lessons learned and technical considerations. Plast Reconstr Surg Glob Open. 2022;10(3):e4155. doi:10.1097/GOX.0000000000004155. PMID: 35371898
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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