Total Scalp Replantation

Nasır, Serdar; Karaaltın, Mehmet Veli; Erdem, Adnan

doi:10.1097/scs.0000000000001646

Cited by 11 publications

(8 citation statements)

References 11 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, the immobility of the head during the prolonged period of coma after the trauma has also been discussed. Furthermore, Nasir et al 12 claimed that the occiput experienced a greater force during the trauma, which could lead to greater vessel damage in that specific area. In a recent study, a halo fixation device was used as a possible solution to reduce pressure-related scalp injury.…”

Section: Discussionmentioning

confidence: 99%

Microsurgical Scalp Replantation: Lessons Learned and Technical Considerations

Wechselberger

Pumberger

Schwaiger

et al. 2022

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary: 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.

show abstract

Section: Discussionmentioning

confidence: 99%

Microsurgical Scalp Replantation: Lessons Learned and Technical Considerations

Wechselberger

Pumberger

Schwaiger

et al. 2022

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Kotamarti

Heiman

Camargo

et al. 2021

J Reconstr Microsurg

View full text Add to dashboard Cite

Introduction Replantation is the ideal treatment in traumatic scalp defects to provide immediate coverage with restoration of hair-bearing skin. However, data are limited to case reports and small case series. Comprehensive analysis of techniques and outcomes is not available. Our aim was to systematically analyze the available literature to better understand management and postoperative outcomes of patients undergoing scalp replantation. Methods A systematic review of the PubMed, Cochrane, and EBSCO databases was performed in October 2019. Search terms included “replantation,” “replant,” “revascularized,” “revascularization,” “avulsion,” and “scalp.” Only papers reporting microvascular replantation of completely avulsed scalps, including case reports, were included. Review articles, non-English language articles, articles discussing nonreplant coverage, incomplete scalp avulsions, and articles discussing delayed scalp replantation were excluded. Data extracted included demographics, percent of scalp affected, mechanism, operative technique, and postoperative outcomes. Statistical analysis was performed using Mann–Whitney U tests, Kruskal–Wallis, and chi-squared tests. Results From a total of 704 initial results, 61 studies were included for analysis comprising 149 scalps. Complete survival was achieved in 54.7%, partial survival in 38.9%, and failure in 6.7%. Total ischemia time greater than 12 hours was associated with complete replant failure. Arterial anastomoses appeared to protect against complete loss. The number of venous repairs, proportion of venous-to-arterial repairs, use of vein grafts, thromboprophylaxis, or intraoperative complications did not affect outcomes. Patients required significant volumes of blood products, which was associated with partial success. Salvage rate after unplanned return to the operating room was 60.0%. Normal hair growth was achieved in all surviving native scalp tissue. Conclusion Scalp replantations, while technically challenging, are the ideal treatment for scalp avulsions. Fortunately, these have high rates of success. And as a focal point of a patient's appearance, this is invaluable in restoration of a sense of normalcy.

show abstract

“…Prophylactic leeching is likely not indicated and should be initiated when venous congestion initially presents itself. Lastly, the replanted specimen may exhibit signs of marginal necrosis, particularly at the site of traumatic avulsion and zone of adherence of the occiput 7 . The posterior scalp frequently exhibits delayed healing and necrosis after replantations also due to venous congestion and poor regional perfusion, especially if STA's or other anterior feeding vessels are utilized.…”

Section: Discussionmentioning

confidence: 99%

Successful Microsurgical Scalp Replantation Utilizing Loupe Magnification

Chopan

Leyngold

Ching

2021

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Total scalp avulsion is a rare injury that poses a unique reconstructive challenge. Microsurgical replantation is considered the first-line choice; yet anastomotic efforts may be strained to find suitable recipient and target vessels. Concomitant injuries may also delay or hinder operative intervention. These complex scenarios are difficult to navigate and necessitate multidisciplinary input to optimize outcomes. As such, the authors present an illustrative case report of a total scalp avulsion injury that underwent successful microsurgical replantation. This report highlights the novel use of loupe magnification in scalp replantation and reviews technical and clinical nuances that facilitate a favorable reconstruction.

show abstract

Total Scalp Replantation

Cited by 11 publications

References 11 publications

Microsurgical Scalp Replantation: Lessons Learned and Technical Considerations

Microsurgical Scalp Replantation: Lessons Learned and Technical Considerations

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

Successful Microsurgical Scalp Replantation Utilizing Loupe Magnification

Contact Info

Product

Resources

About