Zhang J, Guo L, Ning H, Pei J, Han D, Liu X, Liu J, Song B. Modified Scalp Replantation for Total Scalp Avulsion: Scalp-Shifting Technique.
J Craniofac Surg 2024;
35:1564-1567. [PMID:
38830023 DOI:
10.1097/scs.0000000000010373]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/05/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND
Scalp replantation is the best treatment for scalp avulsion due to its functional and esthetic benefits. Regular scalp replantation requires only unilateral or bilateral superficial temporal vascular anastomosis. However, shear force always damages vessels in severe scalp avulsions. Short, superficial temporal vessels (STVs) make tension-free anastomosis challenging.
PURPOSE
The objective of this article is to improve the regular scalp replantation technique. When the STVs are short, tension-free anastomosis, and cosmetic symmetry can be achieved without vein grafts or vascular replacement.
METHOD
This study retrospectively reviewed 18 patients with scalp avulsion, of which 10 underwent scalp-shifting replantation, and 8 underwent regular scalp replantation with direct anastomosis of the STVs. Postoperatively, the authors, assessed whether there was a significant difference in the percentage of scalp survival and in the facial symmetry of patients between the 2 methods.
RESULT
The percentages of scalp survival and facial symmetry were good after surgeries using both methods, and no significant differences were observed.
CONCLUSION
The authors use scalp-shifting replantation to create tension-free anastomoses in cases where scalp avulsion injuries have left the superficial temporal arteries too short. This technique ensures facial symmetry, scalp reimplantation survival, and equally excellent results in function and esthetics.
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