American Society of Hirudotherapy

Entire scalp replantation: case report and review of the literature

Research article published in Journal of reconstructive microsurgery (1995)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsArashiro et al. · Journal of reconstructive microsurgery, 1995

Abstract

A case of successful replantation of a totally avulsed scalp in a 40-year-old woman is presented. During a 19-hr surgical procedure, bilateral superficial temporal arteries and veins were anastomosed. The postoperative course was uneventful, except for partial necrosis of the distal end of the avulsed flap, i.e., the occipital region. Since the first successful scalp replantation using microsurgical technique was reported in 1976, the authors have found at least 32 subsequently reported cases. Of these, there were 22 cases of entire scalp avulsion (more than 80 percent of the scalp), including 15 females and seven males. A summary of these cases is included. From analysis of the reported cases of entire scalp avulsion, the keys to success in scalp replantation are considered to be the adequate selection of vessels for repair and the use of vein grafts, if necessary.

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

Publication typeCase ReportsJournal ArticleReview
Indexed MeSH termsAdultAnastomosis, SurgicalFemaleFollow-Up StudiesHumansMicrosurgeryNecrosisOccupational DiseasesReplantationScalpTemporal ArteriesTemporal Muscle

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This is a case report of successful microsurgical replantation of a totally avulsed scalp in a 40-year-old woman, with bilateral superficial temporal artery and vein anastomoses over a 19-hour procedure and an uneventful course apart from partial necrosis at the distal occipital flap edge; it is paired with a review of at least 32 prior reported cases (22 of entire scalp avulsion) and concludes that adequate vessel selection and use of vein grafts when needed are keys to success. Scalp replantation is a classic scenario where venous outflow is the limiting factor and medicinal leeches are used adjunctively to relieve congestion, so this combined case report and literature review is pertinent background, even though it does not describe leech therapy. The caveat is that it rests on a single case plus a narrative case-by-case literature summary, which together offer descriptive, not controlled, evidence.

Citation

Entire scalp replantation: case report and review of the literature.

Arashiro et al. · Journal of reconstructive microsurgery, 1995

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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