Scalp replantation in a cervical spine injury patient: Lessons learnt

Abstract

Total scalp avulsion injury with cervical spine injury is rare. This article is to describe the technical difficulties and precautions to be taken during anatomical replantation. The patients with cervical spine injury should not be considered as an absolute contraindication for anatomical replant if patients are fit for general anaesthesia. We found that the supratrochlear and supraorbital vessels which are anterior and superficial temporal vessels which are lateral can be used to replant without much technical difficulty. We conclude that anatomical replant is always better keeping in mind the technical limitations of anatomical replant in case of cervical spine injury.

Total Scalp Replantation after Traumatic Avulsion

“…Malmande et al reported scalp replantation in a patient with suspected cervical spine injury and limited neck mobilization. 5 We report this case to document the success even in nonideal conditions and emphasize the importance of attempting replantation even in peripheral hospitals.…”

Identifying Factors Affecting Outcomes in Scalp Replantation: A Systematic Review of the Literature

“…Of 704 initial results, 61 studies were selected for data analysis. 1 2 4 5 6 7 8 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 ( Fig. 1 ) Nine studies included sample sizes of five-or-more patients.…”

“…Additionally, vertebral fractures, skull fractures, and intracranial bleeding have been reported in these patients. 44 81 82 The need for cervical collar stabilization may complicate patient positioning. One group has reported managing such a case by ectopic replantation of an avulsed scalp to the forearm to allow for acute stabilization of severe cervical spine injury and then secondary replantation to the head later.…”