Total scalp replantation: staged reconstruction of occipital necrosis with tissue expansion
Case report published in J Craniofac Surg (2026)
Abstract
Total scalp avulsion is a rare but devastating injury that can lead to significant functional and aesthetic morbidity.Microsurgical replantation is considered the treatment of choice when technically feasible;however, complications such as partial necrosis may occur despite successful vascular anastomoses. We report a case of scalp replantation in a 15-year-old girl who sustained total scalp avulsion after her hair became entangled in agricultural machinery.Following successful replantation, partial necrosis developed in the occipital region.Serial debridement demonstrated that the necrosis involved the skin and subcutaneous tissue while the galea aponeurotica remained intact.The defect was temporarily managed with split-thickness skin grafting.In the delayed stage, tissue expansion was performed in the adjacent viable replanted scalp, followed by excision of the grafted alopecic area and reconstruction using expanded hair-bearing scalp. This staged approach provided stable wound coverage and enabled restoration of hair-bearing scalp, representing an effective salvage strategy for partial necrosis after scalp replantation.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Total scalp replantation with staged reconstruction of occipital necrosis using tissue expansion.
Por qué esto importa para la hirudoterapia
This article reports a case of total scalp avulsion in a 15-year-old girl managed with microsurgical replantation, which was subsequently complicated by partial occipital necrosis involving skin and subcutaneous tissue. The necrosis was managed through staged debridement, temporary split-thickness skin grafting, and later tissue expansion with reconstruction using expanded hair-bearing scalp. The abstract describes this staged approach as an effective salvage strategy for partial necrosis after scalp replantation. No leeches, hirudotherapy, or leech-derived products are mentioned anywhere in the abstract. Therefore, this article has no direct relevance to ASH's domain, and no hirudotherapy connection can be established from the abstract.
Citación
Total scalp replantation: staged reconstruction of occipital necrosis with tissue expansion.
Dadaci et al. · The Journal of craniofacial surgery, 2026
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026