Microsurgical Replantation of Completely Avulsed Scalp Segment Recovered From Under Snow

Complete scalp avulsion is a devastating injury resulting in permanent disfigurement. Replantation is the procedure of choice whenever possible. This report describes a successful case of microsurgical reattachment of complete scalp avulsion of temporoparietal segment in a 72-year-old female patient after her hair was tangled in the hoof crack of a horse when the animal slipped on ice and fell on a cold New England night. The amputated segment could be recovered from under snow only after 4 hours following the incident. The procedure involved microvascular anastomoses of superficial temporal artery and vein. The recovery was uneventful, with complete survival of the replant, including the severely crushed segment. There was no need for any transfusion. Long term follow up revealed excellent aesthetic outcome with complete hair growth. This report presents a case experience of successful scalp replantation even after the amputated part was exposed to freezing conditions for 4 hours.