12例全头皮撕脱伤的治疗

Treatment for Avulsion of Whole Scalp:A Report of 12 Cases

全头皮撕脱伤采用血管吻合头皮再植术是较理想的方法，但技术难度大，成功率不高，一旦失败，不但损失了可制成皮片回植的头皮，而且使创面失去了一期修复的时机，治疗时间延长，增加病人精神和经济负担，因此应严格掌握手术指征，对不能行吻合血管再植术或技术力量不够、吻合血管成功把握不大者，应积极采取中厚皮片回植术。本组１２例中，５例吻合血管的再植术中，１例失败，４例部分成活。７例行中厚皮片回植，５例全部成活，２例７０％成活。

Avulsion of whole scalp was mainly caused by sudden mechanical violence when long pigtail was drawn into high speed revolving machine.At present vasoscalptomy is advocated,however,skin grafting often fails.Once transplantation fails,it loses not only the scalp slice which can be replanted,but also the chance of direct repair of the wound.If there is a severe injury of blood vessels in the scalp which doesn't permit vasoscalptomy,or no proficient technical skill,replantation of middle thickness scalp slice will be preferred.Vasoscalptomy was carried out in 5 cases,among which 1 has completely failed,4 survived partially.Replantation of middle thickness scalp slice has been finished in 7 cases,of whom 5 survived entirely and 2 survived 70%.(Original article on page 164)