Two cases of scalp reimplantation based on one artery and one vein with interposed vein grafts

The authors report their experience in successful reimplantation of avulsed scalp in two patients with one arterial and one venous anastomosis to the superficial temporal vessels. In both cases a double vein graft, harvested from the dorsum of the hand, was interposed between the pedicle of the scalp and the recipient temporal vessels to avoid tension after trimming of the damaged segments. Scalp replantation based on two or more vessels has previously been reported in the literature. In the present cases, the complete survival of the scalp on only a single vascular pedicle suggests that replantation should be considered also when the available vessels for the anastomosis are few. Moreover, even if these reconstructions are lengthy, a prolonged ischemic interval does not appear to be a significantly limiting factor for the success of the revascularization. The cosmetic and psychological success of these cases lend support to the idea that one should always attempt a microvascular replantation of avulsed scalps.