Methods
The surgery was conducted in two groups: one group managed the scalp by
cutting the hair, disinfecting the scalp with iodine, trimming the skin
edges, identifying and marking blood vessels, while the other group
managed the skull by disinfecting the skin and wound with iodine. After
cleaning the wound, carefully identifying the blood vessels, and marking
the superficial temporal arteries, veins, and occipital subcutaneous
veins on both sides for later use, a spider-web suture technique was
used. Starting from the cranial vertex, the scalp was meticulously
sutured in place, one layer at a time, with absorbable sutures. The
subcutaneous tissues on the left and right temporal sides were sutured
and fixed to the periosteum. Under the surgical microscope, the two
arteries and four veins were delicately anastomosed using 10-0
non-traumatic sutures, restoring blood circulation to the scalp. The
subcutaneous tissues were sutured and fixed to the periosteum of the
skull using 4-0 absorbable sutures to ensure close approximation of the
skin to the skull and prevent subcutaneous hematoma. Drainage tubes were
placed under the scalp and incision sites (Figure 2). Postoperatively,
the drainage tubes were removed on the second postoperative day.