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Microsurgical Scalp Replantation: Lessons Learned and Technical Considerations
Gottfried Wechselberger1, Peter Pumberger1, Karl Schwaiger1
1Department Plastic, Aesthetic and Reconstructive Surgery, Hospital of the Brothers of St. John of Gods, Salzburg, Austria.
Plastic and Reconstructive Surgery. Global Open
|April 4, 2022
Summary
Total scalp avulsion, a severe injury, can be treated with microvascular replantation. This case highlights successful reattachment using a vein graft and aesthetic refinement with an expander, promoting hair regrowth.
Area of Science:
- Microsurgery
- Reconstructive Surgery
- Trauma Surgery
Background:
- Total scalp avulsion is a severe soft-tissue injury.
- It commonly affects women due to hair entrapment in machinery.
- Microvascular replantation offers a potential treatment option.
Observation:
- A patient with total scalp avulsion was treated with microvascular replantation.
- An 8 cm vein graft was used for superficial temporal artery reanastomosis.
- Post-replantation, a tissue expander was utilized for aesthetic improvement.
Findings:
- Successful microvascular replantation of the avulsed scalp was achieved.
- The patient experienced excellent aesthetic outcomes after using a tissue expander.
- Partial skin necrosis did not preclude hair growth in remaining areas.
Implications:
- Scalp replantation should be considered in all viable cases.
- Tissue expanders can address hairless areas resulting from necrosis.
- Halo fixation devices may prevent postoperative pressure ulcers.
