严重全头皮撕脱伤的再植治疗

Replantation of severe total scalp avulsion

报道我院自１９９０ ～１９９６ 年治疗严重全头皮完全撕脱伤５ 例，经实施显微外科全头皮再植的成功经验。将撕脱完整的头皮经过彻底清创后，分别吻合两侧的头部颞浅动、静脉行头皮再植，当清创切除损伤血管后的缺损共８ 条，长度３ ～８ｃｍ ，即从前臂取浅静脉移植架桥修复。使撕脱头皮在伤后１０ ～１３ 小时重新恢复血液供应。经过术后随访至１ 年，全头皮再植成活９５％ ～１００ ％ ，全部头皮都长出了３０ｃｍ 长乌黑的秀发。结论：大面积头皮撕脱伤时，只要头皮层内的颞浅动、静脉主干血管无损伤和头皮尚完整，行撕脱头皮的再植治疗可获最佳效果。

Five cases of severe scalp avulsion were replanted successfully with microvoscular anastomosis in our hospital from year 1990 to 1996. Careful debridement was necessary for the avulsed scalp and head wound, replantation were there after made by anastomosis of bilateral superficial temporal artery and its paired veins. The debridement removal of damaged vessels left a 5cm to 8cm gap which were bridged by vein grafts taken from forearm. The repair established blood flow through the scalp 10 to 13 hours after injury. During 1 month to one year's follow up, to get over 95% to 100% of replanted scalp survived with luxuriant hair. Conclusion: It is possible fine results when large area scalp avulsion were replanted successfully if the main superficial tempor artery and its paired veins were undamaged of the scalp avulsion.