Clinical efficacy of in situ replantation of total scalp avulsion with anastomotic blood vessels
10.3760/cma.j.cn114453-20211214-00466
- VernacularTitle:吻合血管的全头皮撕脱伤头皮原位再植的临床疗效
- Author:
Jiulong LIANG
1
;
Qiang HUI
;
Yuan JIN
;
Jingtao HE
;
Hang YIN
;
Qianqian LIU
;
Yu DU
;
Meiling ZHOU
;
Kai TAO
Author Information
1. 北部战区总医院烧伤整形科，沈阳 110016
- Keywords:
Total scalp avulsion;
Microsurgery;
Replantation;
Cosmetic suture technique
- From:
Chinese Journal of Plastic Surgery
2022;38(11):1265-1269
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of microsurgical technique combined with cosmetic suture technique in situ replantation of total scalp avulsion.Methods:The clinical data of patients with total scalp avulsion admitted to the Department of Burn and Plastic Surgery of General Hospital of Northern Theatre Command from January 2015 to December 2020 were collected. All patients were treated by microsurgical technique combined with cosmetic suture technique. Thorough debridement was performed during the operation. Active anti-shock treatment was given to the patient with hemorrhagic shock. The vascular was explored and labeled. The vascular anastomosis was conducted by microsurgical technique. The venous anastomosis was performed in the first place. The arterial anastomosis was performed according to the patient's condition. Symptomatic treatment, such as routine anti-coagulation, was given to patients after the operation. An infection prevention strategy was performed in patients. The recovery of patients was observed.Results:A total of six patients were involved in this study. All patients were females, aged from 36 to 55 years old. Various degrees of wound contamination can be seen, and one patient with hemorrhagic shock. The superficial temporal vein, supraorbital vein and sentinel vein were anastomosed in two patients, and the superficial temporal vein and sentinel vein were anastomosed in four patients. The superficial temporal artery and supratrochlear artery were anastomosed in two patients, and the superficial temporal artery was anastomosed in four patients. All patients were followed up for 3 months to 2 years, averaging 13.71 months. More than 90% of the scalp survived in three patients, 80% in two patients, and 50% in one patient. The necrotic area survived after replantation of a split-thickness skin graft. The sensory function of surviving scalp after replantation was slightly regressed. The hair growth was normal. Only superficial linear scar left. All patients were satisfied with the efficacy.Conclusions:The application of the microsurgical technique for vascular anastomosis combined with cosmetic suture technique for repair can achieve good clinical efficacy in situ replantation of total scalp avulsion.
