Total Scalp Replantation after Traumatic Avulsion

Singh, Kuldeep; Aggarwal, Krittika

doi:10.1055/s-0040-1716309

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…The traumatic avulsion of a scalp will often result in haemorrhage. Singh et al described a blood loss of approximately 400 mL, which is similar to our case 1. The blood loss was not severe enough for the patient to need transfusion.…”

Section: Discussionsupporting

confidence: 82%

“…Singh et al described a blood loss of approximately 400 mL, which is similar to our case. 1 The blood loss was not severe enough for the patient to need transfusion. In our case, the level of avulsion was loose areolar tissue which is similar to the case presented by Singh et al 1 Due to the low frequency of total scalp avulsions, no official consensus on treatment exists.…”

Section: Discussionmentioning

confidence: 99%

“…A total scalp avulsion is a rare and potentially life-threatening injury. Only a limited amount of literature is published on this kind of trauma, mainly case reports or case series 1 2. If possible, microsurgical replantation of the scalp is the preferred treatment 3 4.…”

Section: Introductionmentioning

confidence: 99%

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Microsurgical replantation of a traumatic total scalp avulsion

et al. 2023

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We present a rare case of microsurgical replantation of a total scalp avulsion. A woman in her mid-60s was renovating a tractor when her hair was caught in a column drill resulting in traumatic scalp avulsion. The avulsed scalp involved the eyebrows and the entire hair-covered part of the scalp. The prehospital management and the conservation packing of the scalp was very effective. Microsurgical replantation was achieved with anastomoses of the left superficial temporal artery and one temporal vein on each side. The combination of the prehospital treatment and our university hospital setup made it possible to reattach the scalp with an ischaemia time of approximately 5 hours. A functional and aesthetically pleasing outcome was achieved, and the patient was discharged 6 days postoperatively with a vital scalp and no complaints. Five months postoperatively, she has no sign of alopecia and is regaining sensation and function of the scalp.A woman in her mid-60s was renovating a tractor when her hair was caught in a column drill resulting in traumatic scalp avulsion. The avulsed scalp involved the eyebrows and the entire hair-covered part of the scalp. The prehospital management and the conservation packing of the scalp was very effective.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Microsurgical replantation of a traumatic total scalp avulsion

et al. 2023

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“…Микрохирургическая реплантация -наиболее оптимальный метод лечения таких повреждений [17]. Хирург при первичной хирургической обработке раны возвращает кожно-апоневротический лоскут на раневое ложе, полагаясь на случайное приживление последнего.…”

Section: Discussionunclassified

Emergency surgical treatment of a child with a traumatic brain injury and complete rejection of the scalp due to a bite (clinical case)

Zakharchuk¹,

Zakharchuk²,

Gaibov³

et al. 2021

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Total separation of the scalp is a serious trauma in clinical practice. Common in adult women and rare in children. Among children, the most common cause of such injuries is animal bites, including dog bites. The article presents the experience of treating a two-year-old child who was admitted to the Regional Clinical Hospital No. 2 in Tyumen (Russia) with an extensive scalped wound of the scalp in combination with craniocerebral trauma, traumatic shock, multiple bitten wounds of the soft tissues of the head with a violation of the integrity of the upper lacrimal tubule. Immediately from the moment the child was transported by the ambulance team, anti-shock, antibacterial, decongestant, symptomatic therapy was started, primary surgical treatment of wounds was performed with restoration of the integrity of the upper lacrimal canal of the right eye. The child had no indications for neurosurgical intervention. The standard treatment for a detached scalp is, if possible, microsurgical replantation, but due to the impossibility of performing microsurgical replantation in this case (an infected wound, a skin flap was recognized as unviable by an interdisciplinary council), the defect was closed on a delayed basis with a fullthickness skin graft taking into account the blood supply and anatomical features bed. In this case, during the period of scalp plasty, there were no postoperative complications, the engraftment of autodermal grafts was satisfactory, and the healing of donor wounds was also satisfactory. The child was discharged for the outpatient follow-up stage after 3 months of inpatient treatment. In our opinion, the main reasons for achieving a good clinical result were an interdisciplinary approach to treatment, a combination of correctly performed primary surgical treatment of a wound, subsequent timely complex treatment in a specialized department, and a high regenerative potential of the child. In our opinion, the choice of the method of reconstructive intervention in patients with soft tissue and soft tissue bone defects of the scalp requires a differentiated approach, taking into account the etiology of the defect, its anatomical features and the possibility of compensating for aesthetic disorders. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: children, traumatic brain injury, scalp wound, scalp avulsion, treatment.

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“…Scalp amputation can lead to severe injury, permanent hair loss and massive blood loss. Partial defects can be managed by local flaps or skin grafts, while complete detachment may require free flap or replantation, with consideration of ischemia time and blood supplies for scalp survival [ 1 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Successful replantation of total scalp amputation due to dog bites in geriatric patient with prolonged tissue ischemia and comorbidities: a case report

Muzakkie

Hasbi

Tardha

2023

Journal of Surgical Case Reports

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Traumatic scalp amputation is a rare and life-threatening case causing massive blood loss and serious tissue damage. This report aims to record a successful scalp replantation on a 69-year-old woman with total scalp amputation due to dog bites. The challenges of this case were age, prolonged tissue ischemia and several comorbidities such as high glucose index (uncontrolled diabetes mellitus), hypertension and obesity. After 2 hours of admission, 9 hours of stabilization and 7 hours of revascularization, left superficial temporal artery and vein end-to-end anastomosis was successful, adding to 18 hours total of warm tissue ischemia time. The patient was discharged on Day 8 without signs of reperfusion injury or infection. Elderly patients with comorbidities and long-term tissue ischemia may be at risk for reperfusion injury and infection. However, sufficient vascular anastomosis, good tissue quality and optimal evaluation can achieve a good result.

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Total Scalp Replantation after Traumatic Avulsion

Cited by 3 publications

References 4 publications

Microsurgical replantation of a traumatic total scalp avulsion

Microsurgical replantation of a traumatic total scalp avulsion

Emergency surgical treatment of a child with a traumatic brain injury and complete rejection of the scalp due to a bite (clinical case)

Successful replantation of total scalp amputation due to dog bites in geriatric patient with prolonged tissue ischemia and comorbidities: a case report

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