American Society of Hirudotherapy

Successful management of scalp avulsion with full-thickness graft

Case report published in Clin Case Rep (2022)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsAlmoshantaf et al. · Clinical case reports, 2022

Abstract

Scalp avulsion injuries are one of the life-threatening traumatic injuries. Rapid management in the emergency department is vital to the successful rescue of an avulsed scalp. There are many replantation methods to treat scalp avulsion, so the best aesthetic and functional results are achieved. Skin grafting, free flaps, microvascular surgery, and hyperbaric oxygen are all suitable for reconstructive plans. We report a rare case of a scalp avulsion injury in a female due to an entanglement of a headscarf in a motorized machine resulting in defects and tissue loss of the hair-bearing skin, nasal area, forehead, left ear, and bilateral eyelids and eyebrows. Preoperative management included early blood transfusion, intravenous fluids, and wound compression after rapid physical examination. Reconstructive surgery was performed using a full-thickness skin graft and the outcomes were pristine. There are no clear guidelines to determine which reconstructive method is superior to another in each condition. Our case demonstrates that relatively primitive methods like skin grafting can give greater results if done with circumspection.

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

Publication typeCase ReportsJournal Article

Summary

Scalp-avulsion case successfully managed with full-thickness graft as alternative or salvage following primary microsurgical effort.

Why This Matters for Hirudotherapy

This case report describes successful reconstruction of a severe scalp avulsion injury in a female patient — involving hair-bearing skin, nose, forehead, ear, and eyelids — using a full-thickness skin graft, with pristine outcomes. The abstract discusses emergency management including blood transfusion, fluid resuscitation, and various reconstructive options (skin grafting, free flaps, microvascular surgery, hyperbaric oxygen). There is no mention of leeches, hirudotherapy, hirudin, or leech-derived substances. While leech therapy is sometimes used in flap and replantation surgery for venous congestion, this case did not employ it. The article has no direct relevance to ASH's domain.

Citation

Successful management of scalp avulsion with full-thickness graft.

Almoshantaf et al. · Clinical case reports, 2022

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

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