Surgical treatment of the totally avulsed scalp

Scalp avulsion is associated with significant physical and psychological morbidity. In the past, extended hospitalizations and multiple procedures to achieve coverage were the rule and the chronic morbidity of partial thickness coverage was high. Microvascular surgery now allows an initial chance for successful replantation or a subsequent one-stage reconstruction with well-vascularized tissue with a 90 per cent chance of success. The use of the free latissimus dorsi muscle has been a significant advance in this regard. When progress in immunologic research allows allotransplantation with little morbidity, scalp transplantation may become a useful reconstructive tool.