American Society of Hirudotherapy

Modified scalp replantation for total scalp avulsion: scalp-shifting technique

Case report published in J Craniofac Surg (2024)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsZhang et al. · The Journal of craniofacial surgery, 2024

Abstract

BACKGROUND: Scalp replantation is the best treatment for scalp avulsion due to its functional and esthetic benefits. Regular scalp replantation requires only unilateral or bilateral superficial temporal vascular anastomosis. However, shear force always damages vessels in severe scalp avulsions. Short, superficial temporal vessels (STVs) make tension-free anastomosis challenging. PURPOSE: The objective of this article is to improve the regular scalp replantation technique. When the STVs are short, tension-free anastomosis, and cosmetic symmetry can be achieved without vein grafts or vascular replacement. METHOD: This study retrospectively reviewed 18 patients with scalp avulsion, of which 10 underwent scalp-shifting replantation, and 8 underwent regular scalp replantation with direct anastomosis of the STVs. Postoperatively, the authors, assessed whether there was a significant difference in the percentage of scalp survival and in the facial symmetry of patients between the 2 methods. RESULT: The percentages of scalp survival and facial symmetry were good after surgeries using both methods, and no significant differences were observed. CONCLUSION: The authors use scalp-shifting replantation to create tension-free anastomoses in cases where scalp avulsion injuries have left the superficial temporal arteries too short. This technique ensures facial symmetry, scalp reimplantation survival, and equally excellent results in function and esthetics.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsHumansScalpReplantationMaleRetrospective StudiesFemaleAdultMiddle AgedAnastomosis, SurgicalTreatment OutcomeAdolescentTemporal Arteries

Summary

Modified scalp-shifting technique for total scalp avulsion replantation.

Why This Matters for Hirudotherapy

This retrospective study reviewed 18 patients with scalp avulsion, comparing regular scalp replantation (8 patients) with a modified 'scalp-shifting' technique (10 patients) designed to achieve tension-free anastomosis of the superficial temporal vessels without vein grafts or vascular replacement. The abstract reports that both methods yielded good percentages of scalp survival and facial symmetry with no significant differences observed between the two groups. The abstract makes no mention of leeches, hirudotherapy, venous congestion management, or the leech secretome. This article has no defensible relevance to ASH's domain.

Citation

Modified scalp replantation for total scalp avulsion: scalp-shifting technique.

Zhang et al. · The Journal of craniofacial surgery, 2024

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.