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.