Abstract
For centuries, cranial outer table perforations were used to treat scalp avulsions that compromised the underlying periosteum. However, its use declined with the development of newer alternatives such as free-flap transpositions and scalp replantation. We report a case of extensive scalp avulsion with a large area of bone devoid of its periosteum. Outer calvarial plate perforations were drilled to promote granulation tissue growth. Skin grafts were used as a temporary coverage. The remaining scalp was then expanded, and the flaps obtained allowed a satisfactory coverage of the area of alopecia. The objective of this report is to bring this treatment method again into the set of possibilities to be considered when planning scalp reconstruction, as it is a feasible alternative and enables good results.
This is a preview of subscription content, log in via an institution to check access.
References
Mitchell GF (1933) Total avulsion of the scalp: a new method of restoration. Br Med J 1:13–15
Robinson F (1952) Complete avulsion of the scalp. Br J Plast Surg 5:37–50
Yin JW, Matsuo JM, Hsieh CH, Yeh MC, Liao WC, Jeng SF (2008) Replantation of total avulsed scalp with microsurgery: experience of eight cases and literature review. J Trauma 64:796–802
Ducic Y (2009) Reconstruction of the scalp. Facial Plast Surg Clin N Am 17:177–187
Flaherty F (1914) Complete avulsion of the scalp: with a report of a case. Ann Surg 59:186–190
Osborne MP (1950) Complete scalp avulsion: rational treatment; report of cases: experimental basis for production of free, hair bearing grafts from avulsed scalp itself. Ann Surg 132:198–213
Jeong SH, Koo SH, Han SK, Kim WK (2010) An algorithmic approach for reconstruction of burn alopecia. Ann Plast Surg 65:330–337
Newman MI, Hanasono MM, Disa JJ, Cordeiro PG, Mehrara BJ (2004) Scalp reconstruction: a 15-year experience. Ann Plast Surg 52:501–506
Simon E, Sellal S, Chassagne JF, Stricker M, Duroure F (2008) Total, nonreplantable scalp avulsion: utility of artificial dermis. Eur J Plast Surg 30:233–237
Molnar JA, DeFranzo AJ, Marks MW (2000) Single-stage approach to skin grafting the exposed skull. Plast Reconstr Surg 105:174–177
Terzioğlu A, Aslan G, Saydam M (1999) Trephination in the treatment of scalp avulsion: successful application of a historical method. J Oral Maxillofac Surg 57:204–206
Furlanetti LL, de Oliveira RS, Santos MV, Farina JA Jr, Machado HR (2010) Multiple cranial burr holes as an alternative treatment for total scalp avulsion. Childs Nerv Syst 26:745–749
Milcheski DA, Cheroto-Filho A, Goldenberg D, Farias JC, Ferreira MC (2003) Reimplante microcirúrgico das avulsões de couro cabeludo—experiência de 7 anos. Rev Bras Cir Plast 18:47–54
Barry RB, Langtry JA, Lawrence CM (2009) The role of cortical bone fenestration in the management of Mohs surgical scalp wounds devoid of periosteum. Br J Dermatol 160:1110–1112
Becker GD, Adams LA, Levin BC (1999) Secondary intention healing of exposed scalp and forehead bone after Mohs surgery. Otolaryngol Head Neck Surg 121:751–754
Conflicts of interest
The authors declare no conflict of interest.
This work has been fully approved by the Ethics Committee of the Medical School of the Universidade Estadual de Campinas—Unicamp.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Calderoni, D.R., Rosim, E.T. & Kharmandayan, P. Successful calvarial bone salvage using multiple outer table perforation technique on total scalp avulsion injury. Eur J Plast Surg 36, 49–53 (2013). https://doi.org/10.1007/s00238-012-0691-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00238-012-0691-5