The microsurgical replantation of seven complete scalp avulsions: Is one artery sufficient?
The microsurgical replantation of seven complete scalp avulsions: Is one artery sufficient?
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DOI：
10.1016/j.bjps.2012.06.001
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发表时间：
2012-12-01
影响因子：
2.7
通讯作者：
Nguyen, Ha H.
中科院分区：
文献类型：
--
作者：
Nguyen, Ha H.
背景：全头皮撕脱是一种罕见且极具破坏性的事件。显微外科再植是实现理想美容效果的唯一方法。在文献中，大多数研究的样本量有限。大多数作者报告当使用更多的微血管吻合时效果更好。这种策略仍存在争议，因为一些作者认为一条动脉可能就足够了。
方法：2005年至2008年，7名头皮撕脱患者接受了显微外科再植。所有血管吻合均使用颞浅动脉的一个分支进行。我们未使用静脉移植。缺血时间为4 - 16小时。
结果：在6例中，吻合了一条动脉和1 - 2条静脉；在另一例中，吻合了两条动脉和三条静脉。7例头皮再植中有6例成功，并实现了正常的毛发再生。在6例成功的病例中，有5例进行了单动脉吻合。
结论：头皮撕脱在世界范围内罕见，但在我国由于农业和工业缺乏安全可靠的工作条件而相对频繁发生。在无法进行多条动脉吻合的情况下，目前的研究结果表明，颞浅动脉的一个分支可能足以对再植的头皮进行再灌注并取得良好的美学效果。（C）2012英国整形、重建和美容外科医生协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Total scalp avulsion is a rare and devastating event. Microsurgical replantation is the sole method to achieve an ideal cosmetic outcome. In the literature, most studies have reviewed limited sample sizes. Most authors report better outcomes when a greater number of microvascular anastomoses are used. This strategy remains controversial, as some authors have suggested that one artery may be sufficient.Methods: From 2005 to 2008, seven patients who sustained scalp avulsion underwent microsurgical replantation. All of the vascular anastomoses were made with a branch of the superficial temporal artery. We did not use vein grafts. The ischaemia time was 4-16 h.Results: In six cases, a single artery and one to two veins were anastomosed; in another case, two arteries and three veins were anastomosed. Six of the seven scalp replantations were successful and achieved normal hair regrowth. In five of the six successful cases, we performed a single-artery anastomosis.Conclusion: Scalp avulsion is rare around the world but occurs relatively frequently in our country due to the lack of safe and secure working conditions in agriculture and industry. In cases where multiple arterial anastomoses are not possible, the present findings suggest that one branch of the superficial temporal artery may be sufficient to reperfuse the replanted scalp and achieve excellent aesthetic results. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.