No abstract

Replantation of a totally avulsed scalp is a demanding microsurgical procedure with no good alternatives. Here, we present a case of successful scalp replantation after 11 hours of cold ischemia in a 24-year-old woman. The steps of the procedure, the outcomes, and a review of the literature are presented. Adhering to the steps outlined in this report during replantation is vital for success, and allows the serious complications and pitfalls associated with this procedure to be avoided. Following basic plastic surgery principles leads to better aesthetic outcomes. We observed good, even hair growth, and the return of sensation to the skin and frontal muscle function. Replantation of an avulsed scalp is an effective treatment that allows the patient to return to normal life after severe physical and psychological trauma.

The study presented a case of a patient with a neurilemoma of the median nerve. It presented as a six centemeters tumor, at the level of the proximal one third of the arm with only mild paraesthesias within first to third ray of the hand. MRI showed the relationship of the tumor and the median nerve, and allowed for the preliminary diagnose of a benign peripheral neural sheath tumor (neurilemoma or neurofibroma). During the first operation the tumor has not been excised, because nerve reconstruction technique was not available. During the second procedure excision of the tumor has been performed without resection of the median nerve trunk with no postoperative deficiencies. The paper provides a detailed description of a surgical procedure. The presented case, like current publications shows that peripheral neural sheath tumor may be usually excised without resection of the nerve trunk, although the possibility of nerve fascicles injury or the need to excise them in the case of neurofibroma clearly suggest that these type of operations should be carried out in centers with microsurgical facilities.