In India, rural women usually have long hair and share the workload with men. Machines with rotating turbines such as a harvester or sugarcane grinders are extremely dangerous in this context. Women may get their hair entangled and then the whole of the scalp is avulsed from the skull leaving the bare bone and soft tissues exposed. Such extensive raw areas are the immediate threat to life due to a high rate of infection if the immediate cover for the skull is not available.
Traditionally such scalp injury is treated by skin grafts or flaps, but these procedures render the patient totally bald with areas of the unstable scar. We present a similar case with total scalp avulsion treated by scalp Replantation. This is an extremely complicated operation in which very small vessels have to be explored and repaired under the microscope. The duration of such operation is usually more than 12…
