Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series

Although scalp defects can vary in size and thickness, scalp avulsion represents a rare occurrence. This type of lesion may have different origins, but it is usually related to long hair being caught in agricultural machinery. The management of full-thickness scalp defects poses a challenge to the head and neck surgeon due to the possible involvement of neurovascular structures and scar retraction, which can affect the esthetic restoration of the area. Several algorithms for the choice of scalp reconstruction have been proposed in the literature and different techniques are available for extensive scalp defect reconstruction (local soft tissue flap, microvascular free flap, and skin graft combined with dermal substitutes), based upon the scalp defect type. Here we describe six cases of patients with total scalp avulsion, which required a combined reconstruction with a split-thickness skin graft (STSG) and Integra(R) matrix immediately after the trauma.

Automated summary

Although scalp avulsion is rare, it poses challenges in terms of management and esthetic restoration due to involvement of neurovascular structures and scar retraction. Various algorithms and techniques are available for extensive scalp defect reconstruction, depending on the type of defect. In this study, we describe six cases of total scalp avulsion that underwent immediate combined reconstruction with split-thickness skin graft (STSG) and Integra(R) matrix.