Microsurgical replantation for child total scalp avulsion

Total scalp avulsion is an intractable problem in clinical practice. It often occurs in female adults, but rarely in children. In this article, we described the replantation of 2 scalp segments in a 4-year-old girl. The right segment involved the hairy scalp merely, whereas the left one involved the hairy scalp, forehead, eyelid, ear, and part of the face. Warm ischemia time was about 28 hours, and operation time was 13 hours. Although an explorative operation was performed, the left segment survived partly. A relatively satisfactory aesthetic result was obtained by transplanting split skin from the abdomen and part of the survived right avulsed scalp. According to our experience, every effort should be undertaken to save the avulsed scalp, even in severely damaged and juvenile cases.