Introduction
Full-scalp avulsion injuries are often caused by hair being caught in rapidly rotating machinery, frequently accompanied by extensive skin loss and even exposure of the cranial bones[1-2]. The scalp comprises dense hair follicles, a thick dermis, and nerves and blood vessel bundles. Significant blood loss often occurs in cases of full scalp avulsion injury, which can be life-threatening in severe cases. In recent years, advancements in microsurgery have provided new approaches for treating complete scalp avulsion injuries[3-4]. In some cases, the success of microsurgical replantation can be negatively affected by subcutaneous hematoma or inadequate drainage. Most of the literature on scalp avulsion has focused on scalp replantation, with few addressing the scalp’s fixation in replantation. Replantation failure may occur if there is a subcutaneous hematoma or inadequate drainage due to the dense blood vessel bundles in the scalp. In addition to efficiently preventing scalp separation from subcutaneous bruising, suturing the scalp to the periosteum can stop bleeding by compression and increase the survival probability after scalp replantation. In this study, the author presents a technique utilizing a spider web-like suturing method to secure the scalp, effectively preventing subcutaneous hematoma formation and promoting successful replantation of total scalp avulsion injuries and achieves satisfactory results with a follow-up of nine years postoperatively.