부산대학교 도서관

Aim: To present a clinical case of a scalp avulsion injury in a female due to an entanglement of hair in a motorized machine resulting in defects and tissue loss of the hair-bearing skin, partial occipital periosteum, and partial left auricle. Method: A 35-year-old woman was referred to our department after total scalp avulsion caused by motorized machine. The amputated part was in one piece, therefore the first-line treatment was replantation of the scalp, which seemed to be unsuccessful due to flap damage and infection. For this reason, a necrectomy was performed and then the next step was the use of a full and partial thickness skin graft for wounds of the head and face. After 9 days, we observed partial necrosis of these grafts in open bone areas, consequently multiple osteoperforations were planned. While gaining positive results in wound healing using different treatments, skin grafting was performed as the last step. By means of the severity of the trauma and the psychological impact, we provided psychological support for the patient. Results / Discussion: In the case of a particularly complex scalp avulsion, replantation is the first method of choice, but not always successful. Osteoperforations should be considered as an effective method to grow granulation tissue in areas without periosteum layer. Modern wound treatment techniques help to accelerate the treatment. Conclusion: A combination of osteoperforations and subsequent skin grafting is viable for salvaging an avulsed scalp area without periosteum. Combination of proper wounds treatment, psychological support and rehabilitation allows the patient to return to everyday life faster.