Replantation of the totally avulsed scalp

This 1980 case report describes successful microvascular replantation of a totally avulsed scalp used as a free flap; the abstract notes that following surgery one temporal artery was patent while the other was not, that large thrombi were milked from the scalp veins, and that excellent perfusion and eventual hair regrowth were achieved through the single patent artery. The case is relevant to hirudotherapy because scalp replants and free flaps are exactly the setting where venous outflow can fail and clots accumulate in the flap veins -- the clinical problem (venous congestion / thrombus in a marginally perfused flap) that medicinal-leech therapy is conventionally used to relieve while a venous channel re-establishes. Caveat: this is a single historical case report of microsurgical replantation only; it does not mention or test leech therapy, so it illustrates the salvage context rather than providing evidence about hirudotherapy itself.