Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 31:
Replantation Surgery
  A 28-year-old man suffered avulsion of his scalp when his long hair was caught in the drive shaft while he was working beneath his car. He also had a skull bone defect of 5 cm. From Buncke, H.J., Rose, E.H., Brownstein, M.J., and Chater, N.L.: Successful replantation of two avulsed scalps by microvascular anastomosis Plastic Reconstr Surg 5:666, 1978.

FIG. 31-119. Appearance of wound.

FIG. 31-120. The avulsed scalp.

FIG. 31-121. Scalp shaved and ready for revascularization.

FIG. 31-122. Multiple vein grafts were outlined on the dorsum of the foot.

FIG. 31-123. Vein grafts excised.

FIG. 31-124. Early postoperative side view.

FIG. 31-125. Front view.

FIG. 31-126. Late follow-up shows excellent hair growth with complete survival of the scalp. Front view.

FIG. 31-127. Side view.

FIG. 31-128. There has been gradual but near complete return of frontalis function. Patient frowning.

  FIG. 31-129. Patient elevating eyebrows.


A young woman suffered a scalp avulsion when her hair was caught in a laundry ironing machine.

FIG. 31-130. Appearance of injury.

FIG. 31-131. Mechanism of injury.

FIG. 31-132. The fragmented scalp has been avulsed and burned at the same time.

FIG. 31-133. Recipient vessels isolated in the subfascial layer.

FIG. 31-134. Early postoperative appearance. The burn is more apparent at this stage.

FIG. 31-135. Two areas of delayed healing resulted in bald areas.

FIG. 31-136. Full hair growth and contour after excision of the hairless scars.


1. Hoerenz, P.: The operating microscope. Documentation. J. Microsurg. 2:126, 1980.

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