An Unusual Case of Microvascular Replantation of the Scalp

Libermanis, Olafs; Kapickis, Martins; Krustins, Janis

doi:10.1097/00006534-199811000-00074

Cited by 2 publications

(2 citation statements)

References 4 publications

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“…Of 704 initial results, 61 studies were selected for data analysis. 1 2 4 5 6 7 8 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 ( Fig. 1 ) Nine studies included sample sizes of five-or-more patients.…”

Section: Resultsmentioning

confidence: 99%

Identifying Factors Affecting Outcomes in Scalp Replantation: A Systematic Review of the Literature

Kotamarti

Heiman

Camargo

et al. 2021

J Reconstr Microsurg

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Introduction Replantation is the ideal treatment in traumatic scalp defects to provide immediate coverage with restoration of hair-bearing skin. However, data are limited to case reports and small case series. Comprehensive analysis of techniques and outcomes is not available. Our aim was to systematically analyze the available literature to better understand management and postoperative outcomes of patients undergoing scalp replantation. Methods A systematic review of the PubMed, Cochrane, and EBSCO databases was performed in October 2019. Search terms included “replantation,” “replant,” “revascularized,” “revascularization,” “avulsion,” and “scalp.” Only papers reporting microvascular replantation of completely avulsed scalps, including case reports, were included. Review articles, non-English language articles, articles discussing nonreplant coverage, incomplete scalp avulsions, and articles discussing delayed scalp replantation were excluded. Data extracted included demographics, percent of scalp affected, mechanism, operative technique, and postoperative outcomes. Statistical analysis was performed using Mann–Whitney U tests, Kruskal–Wallis, and chi-squared tests. Results From a total of 704 initial results, 61 studies were included for analysis comprising 149 scalps. Complete survival was achieved in 54.7%, partial survival in 38.9%, and failure in 6.7%. Total ischemia time greater than 12 hours was associated with complete replant failure. Arterial anastomoses appeared to protect against complete loss. The number of venous repairs, proportion of venous-to-arterial repairs, use of vein grafts, thromboprophylaxis, or intraoperative complications did not affect outcomes. Patients required significant volumes of blood products, which was associated with partial success. Salvage rate after unplanned return to the operating room was 60.0%. Normal hair growth was achieved in all surviving native scalp tissue. Conclusion Scalp replantations, while technically challenging, are the ideal treatment for scalp avulsions. Fortunately, these have high rates of success. And as a focal point of a patient's appearance, this is invaluable in restoration of a sense of normalcy.

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Section: Resultsmentioning

confidence: 99%

Identifying Factors Affecting Outcomes in Scalp Replantation: A Systematic Review of the Literature

Kotamarti

Heiman

Camargo

et al. 2021

J Reconstr Microsurg

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“…All reports showed good return of hair growth in the surviving segments of scalp. Even though the scalp was turned 180 degree for any reasons, the hair growth is also good [53,54].…”

Section: Scalp Replantationmentioning

confidence: 99%

Application of Microsurgery in Facial Trauma Reconstruction

Chang¹,

Jeng²

2012

MPS

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This article is to review the role of microsurgery in facial trauma reconstruction. Microsurgery was developed since 1960s and had been applied on facial trauma from 1970s to treat amputated scalp, nose, ear and lip. Microsurgical replantation of scalp and small parts of face restores function and achieves aesthetic results, but small size of vessels and venous drainage problems are most technical challenging. In this article, we reviewed many talented authors' work to solve those problems in facial tissue replantation. If defects are huge, we need microsurgical free flaps for reconstruction. The current workhorse is anterolateral thigh flap and we reviewed the versatility and new concepts of the flap. Development of perforator flaps was another milestone of flap reconstruction because of better cosmetic result and lower donor site morbidity. We reviewed the concepts, history and application of perforator flaps. Finally, facial replantation developed in recent 5 years to treat extremely large facial defects which cannot be reconstructed with microsurgical flaps and traditional flaps alone. The task is complex and needs a large team to support the whole procedure. We also reviewed the facial allotransplantation, which is the ultimate application of microsurgery in facial trauma reconstruction.

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An Unusual Case of Microvascular Replantation of the Scalp

Cited by 2 publications

References 4 publications

Identifying Factors Affecting Outcomes in Scalp Replantation: A Systematic Review of the Literature

Identifying Factors Affecting Outcomes in Scalp Replantation: A Systematic Review of the Literature

Application of Microsurgery in Facial Trauma Reconstruction

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