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.