Emergency management of total scalp avulsion

Scalp avulsion is a rare but severe injury and usually happens as an industrial accident. This report concerns a successful salvage in scalp avulsion resulting from hair entrapment in a rotating machine. Most of the literature on scalp avulsion has focused on the technique of scalp replantation, with few addressing preoperative evaluation and preparation in the emergency department. The work-up before surgical treatment will also be reviewed. Scalp avulsion is a threatening blood loss injury. Rapid cessation of bleeding, wound compression and aggressive fluid resuscitation are important. With adequate resuscitation, careful evaluation and replantation as soon as possible the outcome is usually acceptable.