Summary
Background
Total scalp avulsion is a rare and devastating event. Microsurgical replantation is
the sole method to achieve an ideal cosmetic outcome. In the literature, most studies
have reviewed limited sample sizes. Most authors report better outcomes when a greater
number of microvascular anastomoses are used. This strategy remains controversial,
as some authors have suggested that one artery may be sufficient.
Methods
From 2005 to 2008, seven patients who sustained scalp avulsion underwent microsurgical
replantation. All of the vascular anastomoses were made with a branch of the superficial
temporal artery. We did not use vein grafts. The ischaemia time was 4–16 h.
Results
In six cases, a single artery and one to two veins were anastomosed; in another case,
two arteries and three veins were anastomosed. Six of the seven scalp replantations
were successful and achieved normal hair regrowth. In five of the six successful cases,
we performed a single-artery anastomosis.
Conclusion
Scalp avulsion is rare around the world but occurs relatively frequently in our country
due to the lack of safe and secure working conditions in agriculture and industry.
In cases where multiple arterial anastomoses are not possible, the present findings
suggest that one branch of the superficial temporal artery may be sufficient to reperfuse
the replanted scalp and achieve excellent aesthetic results.
Keywords
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Article info
Publication history
Published online: July 09, 2012
Accepted:
June 4,
2012
Received:
December 23,
2011
Footnotes
☆Presented at the American Society for Reconstructive Microsurgery 2010 Annual Meeting, 9–12 January, 2010 at the Boca Raton Resort & Club, Boca Raton, FL, USA.
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
