M S Akram, AH Babar.
Extensive Scalp Avulsion Injuries - Management options and experience at Mayo Hospital, Lahore.
Ann King Edward Med Uni Jan ;3(3):64-6.

Nineteen patients with extensive scalp avulsion injuries were treated at the Department of Plastic & Reconstructive Surgery, Mayo Hospital, Lahore over a period of seven years. Thirteen (70%) of the patients were females. The size of defect varied from a minimum of 30 cm2 to a maximum of 650 cm2. All patients, except one, received primary care elsewhere. Eleven (60%) patients were managed by split skin grafting, six (35%) needed drilling or chiselling of the outer skull table followed by split skin grafting and two patients had reconstruction with local flaps. Majority (85%) of patients required two or less operative procedures. The mean hospital stay was 40.5 days. It has been shown that drilling or chiselling of outer table of skull followed by delayed split skin grafting is an effective way to manage large full thickness scalp defects where replantation or free tissue transfer is either not feasible or possible. Secondary reconstruction following tissue expansion may be employed for better aesthetic results.

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