Ding Wei, Liu Minfeng, Chen Li, Xu Lei, Rui Yongjun, Gu Yudong
From the *Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; †Department of Hand Surgery, Changshu 2nd People's Hospital, Yangzhou Medical College, Changshu, Changshu, Jiangsu Province, China; and ‡Department of Hand Surgery, Wuxi 9th People's Hospital, Suzhou University, Wuxi, Jiangsu Province, China.
J Craniofac Surg. 2015 Mar;26(2):579-81. doi: 10.1097/SCS.0000000000001450.
Total scalp avulsion is a rare but challenging surgical trauma to manage. This study reports 8 cases of total scalp avulsion between 2001 and 2008. In all these cases, the patients were subjected to vascular replantation of the scalp. Microvascular technique after the debridement was used for scalp replantation in all these patients. Study outcome was that between 2001 and 2004, only 1 case had shown major scalp revival and scalp survival whereas in 3 other cases, the scalp survival failed. This may be attributed to the poor microscopic anastomosis. However, between 2005 and 2008, scalp survival was reported in all the cases, which was chiefly due the advanced microsurgical method adopted. In this advanced microsurgical technique, the subcutaneous tissue was suspended by the tight suture of scalp tissue around the anastomotic stoma, which resulted in scalp survival in all the cases. Microsurgical scalp replantation is an effective treatment for scalp avulsion. The key to the successful scalp replantation is high-quality vascular anastomosis involving subcutaneous tissue suspension via the tight suture of scalp tissue around the anastomotic stoma careful debridement.
全头皮撕脱伤是一种罕见但处理起来具有挑战性的外科创伤。本研究报告了2001年至2008年间8例全头皮撕脱伤病例。在所有这些病例中，患者均接受了头皮血管再植术。所有这些患者在清创后均采用微血管技术进行头皮再植。研究结果显示，在2001年至2004年间，只有1例出现了头皮大部存活，而在其他3例中，头皮存活失败。这可能归因于显微吻合技术不佳。然而，在2005年至2008年间，所有病例均报告头皮存活，这主要归功于所采用的先进显微外科方法。在这种先进的显微外科技术中，通过在吻合口周围紧密缝合头皮组织来悬吊皮下组织，这使得所有病例中的头皮均得以存活。显微外科头皮再植术是治疗头皮撕脱伤的有效方法。成功进行头皮再植的关键在于高质量的血管吻合，包括通过在吻合口周围紧密缝合头皮组织来悬吊皮下组织以及仔细清创。
