Microsurgical scalp replantation: lessons learned and technical considerations
Review 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.
Resumen
Lessons-learned review of microsurgical scalp replantation technique with emphasis on operative considerations relevant to leech-supported postoperative care.
Por qué esto importa para la hirudoterapia
Este reporte de caso describe el reimplante microquirúrgico de cuero cabelludo en un paciente con avulsión total del cuero cabelludo, utilizando un injerto venoso de 8 cm para la reanastomosis de la arteria temporal superficial, seguido de la colocación de un expansor tisular para el refinamiento estético. El resumen revisa consideraciones técnicas que incluyen el injerto venoso, el manejo de la necrosis parcial y el uso de fijación con halo para prevenir úlceras por presión occipitales. No se menciona el uso de sanguijuelas, hirudoterapia ni sustancias derivadas de sanguijuelas. Si bien las sanguijuelas medicinales se utilizan a veces en microcirugía reconstructiva para la congestión venosa, este reporte no documenta tal aplicación. Este artículo no tiene relevancia directa para el ámbito de ASH.
Citación
Microsurgical scalp replantation: lessons learned and technical considerations.
Wechselberger G et al. · Plastic and reconstructive surgery. Global open, 2022
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026