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La Revue de Medecine Interne Sep 2020
Topics: Animals; Dermacentor; Female; Humans; Middle Aged; Neck; Scalp; Scalp Dermatoses; Spotted Fever Group Rickettsiosis; Syndrome; Tick Infestations
PubMed: 32456788
DOI: 10.1016/j.revmed.2020.03.006 -
Cutis Aug 2023Affixing a scalp dressing is challenging because of the presence of hair. Many methods have been recommended; their limitations include their effect on aesthetics and...
Affixing a scalp dressing is challenging because of the presence of hair. Many methods have been recommended; their limitations include their effect on aesthetics and discomfort to the patient during the procedure. We describe a method for using hairpins to affix a dressing after scalp surgery or trauma that is sturdy, does not compromise aesthetics, and does not cause additional discomfort.
Topics: Humans; Scalp; Hair; Bandages
PubMed: 37820336
DOI: 10.12788/cutis.0819 -
Journal of Plastic, Reconstructive &... Aug 2021To investigate the reconstructive effectiveness for chronic scalp erosion after deep brain stimulation (DBS).
OBJECTIVE
To investigate the reconstructive effectiveness for chronic scalp erosion after deep brain stimulation (DBS).
BACKGROUND
Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease. However, this surgery is not exempt from hard-ware related complications, especially scalp erosions on scalp. Scalp erosions usually accompanied with chronic infection and wound contamination. If not arrested, infections may spread through the entire equipment which would endanger the patient's life. Along with review of previous literatures, we summarized our experience in the management of scalp erosion and implemented a systemic treatment plan for reconstruction.
METHODS
We retrospectively analyzed the clinical data of patients with chronic scalp erosion after DBS in the past 40 months. The treatment plan was composed of three sequential major steps, including wound care and conservative methods, debridement and local flap, and revaluation of the wound. In each of the cases, wound debridement and local scalp flap repair were conducted, and assisted by negative pressure wound therapy (NPWT) device and double cannula irrigation.
RESULTS
The local scalp flap survived in all 6 patients. The chronic scalp erosions all healed without refractory. The DBS devices still functioned properly after the treatments in all patients. The average follow-up period was 13.33 months (range: 4 to 23 months), and no infection recurrence or re-erosion of the scalp flap was reported.
CONCLUSION
A combination of wound debridement, local scalp flap repair, the use of NPWT device and double cannula irrigation provides effective treatment method for chronic erosion post DBS surgery.
Topics: Aged; Debridement; Deep Brain Stimulation; Female; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy; Parkinson Disease; Plastic Surgery Procedures; Retrospective Studies; Scalp; Surgical Flaps; Surgical Wound Infection; Therapeutic Irrigation
PubMed: 33358678
DOI: 10.1016/j.bjps.2020.11.045 -
Acta Bio-medica : Atenei Parmensis Oct 2022Numerous details regarding preoperative planning of scalp expansion are of the utmost importance for maximizing the results of this procedure.
BACKGROUND AND AIM
Numerous details regarding preoperative planning of scalp expansion are of the utmost importance for maximizing the results of this procedure.
METHODS
The purpose of this paper is to describe the tips and tricks useful for obtaining the best results in scalp expansion.
RESULTS
Basic concepts and operative technique are discussed and detailed.
CONCLUSIONS
In scalp reconstruction, the use of tissue expansion allows to obtain successful results, Anyhow, it is mandatory to follow some basic rules, dictated by anatomical, technical, and psychological considerations.
Topics: Humans; Scalp; Tissue Expansion
PubMed: 36300222
DOI: 10.23750/abm.v93i5.13393 -
The Journal of Dermatological Treatment Dec 2023There has been no validated tool for objectively quantifying the overall condition and characteristics of the scalp. This study aimed to establish and validate a new...
BACKGROUND AND OBJECTIVES
There has been no validated tool for objectively quantifying the overall condition and characteristics of the scalp. This study aimed to establish and validate a new classification and scoring system for evaluating scalp conditions.
METHODS
The Scalp Photographic Index (SPI) using a trichoscope grades five features of scalp conditions (dryness, oiliness, erythema, folliculitis, and dandruff) on a score of 0-3. To evaluate the validity of SPI, SPI grading was performed by three experts on the scalps of 100 subjects along with a dermatologist's assessment of the scalps and a scalp-related symptom survey. For reliability assessment, 20 healthcare providers performed SPI grading for the 95 selected photographs of the scalp.
RESULTS
SPI grading and the dermatologist's scalp assessment showed good correlations for all five scalp features. Warmth showed a significant correlation with all features of SPI and the subjects' perception of a scalp pimple had a significant positive correlation with the folliculitis feature. SPI grading demonstrated good reliability with excellent internal consistency (Cronbach's = 0.90) and strong inter- and intra-rater reliability (Kendall's = 0.84, ICC(3,1)=0.94).
CONCLUSIONS
SPI is an objective, reproducible, and validated numeric system for classifying and scoring scalp conditions.
Topics: Humans; Folliculitis; Photography; Reproducibility of Results; Scalp; Surveys and Questionnaires; Skin Diseases; Health Status Indicators
PubMed: 36809147
DOI: 10.1080/09546634.2023.2181655 -
The Journal of Craniofacial Surgery Jun 2022Microsurgical replantation is considered the best method to treat avulsion or amputation injuries of unique head parts, including the scalp, eyelid, nose, ear, lip, and...
Microsurgical replantation is considered the best method to treat avulsion or amputation injuries of unique head parts, including the scalp, eyelid, nose, ear, lip, and tongue. However, there is currently no report on microsurgical replantation of substi-tutable facial tissues in the literature. This report presents a patient with avulsed facial composite tissue composed of the skin and subcutaneous layers treated by microsurgical replantation. The present case shows that microsurgical replantation of small facial composite tissues is feasible. The authors suggest that the indication spectrum for microsurgical replantation should be expanded beyond current clinical practice.
Topics: Accidents; Amputation, Traumatic; Facial Transplantation; Humans; Male; Microsurgery; Middle Aged; Scalp; Transplantation, Autologous; Treatment Outcome
PubMed: 35240668
DOI: 10.1097/SCS.0000000000008506 -
European Review For Medical and... Apr 2023In Europe, a great number of investigations and studies followed up to develop safer techniques performed by physicians only. Successful dedicated medical protocols...
OBJECTIVE
In Europe, a great number of investigations and studies followed up to develop safer techniques performed by physicians only. Successful dedicated medical protocols included the implant of single fibers with extractable root. The aim of our study was to evaluate the efficacy of biocompatible artificial hair implants in patients with androgenetic alopecia.
PATIENTS AND METHODS
682 patients (488 males and 184 females) aged between 25 and 70 years old, with diagnosed AGA, requiring no invasive nor surgical hair restoration, with problems of baldness and refusing surgical options appealed to the Second Opinion Medical Consulting (Modena, Italy), and were included in the present protocol. Before the treatment, all patients underwent a test implant to rule out hypersensitivity by implanting 100 fibers on a selected skin spot. If no reaction was detected, five weeks later 500-1,200 fibers were further implanted per session at a minimum interval of 5 weeks until the required aesthetic result was achieved.
RESULTS
The average number of sessions for each patient was 5. The average number of implanted fibers was 2,100 (ranging from 800 to 12,000). The treated scalp area returned to normal appearance and tenderness in 3 days.
CONCLUSIONS
The socio-phycological benefit and the life quality improvement of our patients have been the focus of the study. On our side, the accurate selection, small hair units for each implant session, customized dermatological consultation and the use of highly biocompatible fibers have been the proper strategy to achieve the goal.
Topics: Male; Female; Humans; Adult; Middle Aged; Aged; Hair; Alopecia; Scalp; Prosthesis Implantation; Prostheses and Implants
PubMed: 37129328
DOI: 10.26355/eurrev_202304_31336 -
Ultrastructural Pathology Jan 2020Tissue expansion has been widely used for plastic, reconstructive, and esthetic surgeries. A mouse scalp expansion model can effectively mimic the characteristics of...
Tissue expansion has been widely used for plastic, reconstructive, and esthetic surgeries. A mouse scalp expansion model can effectively mimic the characteristics of human skin expansion. However, a detailed study of the histological features and ultrastructural characteristics of expanded scalp is lacking, especially early ultrastructural changes. Here, a mouse scalp expansion model was established and the expanded scalp samples were obtained on day 2 (group I) and 4 (group II) post final injection. Histological analysis revealed epidermal thickening, dermal thinning, subcutaneous fat thinning, and capsule formation in the expanded samples. Ultrastructural evaluation showed the presence of keratinocytes with numerous tonofibrils and damaged mitochondria, and several ruptured collagen fibers and increased number of active fibroblasts and myofibroblasts were observed in the dermis and capsules. Adipocyte dedifferentiation was detected in the expanded samples of both groups, but formation of autophagosomes was only detected in the dermal fibroblasts of group I. Thus, early changes in expanded tissue should be carefully monitored, as it may help avoid dermal thinning and promote expanded tissue regeneration.
Topics: Animals; Cell Dedifferentiation; Fibroblasts; Male; Mice; Mice, Inbred C57BL; Scalp; Skin; Subcutaneous Fat; Tissue Expansion
PubMed: 31989853
DOI: 10.1080/01913123.2020.1720876 -
The Journal of Craniofacial SurgeryThe scalp defect was a clinical common constructive challenge. This research verified the efficacy of the skin-stretching device in the treatment of scalp defect and...
BACKGROUND
The scalp defect was a clinical common constructive challenge. This research verified the efficacy of the skin-stretching device in the treatment of scalp defect and assessed the associated complications.
METHODS
The clinical data of 12 patients with scalp defect treated with skin-stretching device from January 2020 to January 2021 were collected. We used EASApprox skin-stretching device for the treatment of scalp defect. We described a detailed reconstruction procedure for this treatment. We collected the site, distance from wound edge and other characteristics of the wound, and recorded the number of stretching cycles, operation time, closed state, healing time, and observed postoperative complications and wound healing status.
RESULTS
In this research, the scalp defect was mainly caused by pressure ulcer, and mainly located in the parietooccipital site. The average distance from wound edge was 3.2 cm, the average stretching cycles was 4.2 times during the operation, and the average operation time was 43.5 minutes. Ten patients were directly sutured after stretching, and 2 patients underwent first-stage stretching to reduce the wound. The average time of wound healing was 13.5 days. Postoperative follow-up of 3 months, no patients had wound tear, necrosis, 1 patient suffered from wound exudation and infection due to poor nutrition. Skin function and final scar was acceptable.
CONCLUSION
The treatment of skin-stretching device was effective for scalp defect and has the advantages of convenient operation, acceptable functional results, without severe complications. In addition to traditional treatment, this was a promising treatment. However, more clinical and preclinical research of the skin-stretching device were required.
Topics: Humans; Scalp; Skin Transplantation; Treatment Outcome; Skin; Plastic Surgery Procedures
PubMed: 36214652
DOI: 10.1097/SCS.0000000000008856 -
Identifying Factors Affecting Outcomes in Scalp Replantation: A Systematic Review of the Literature.Journal of Reconstructive Microsurgery Jan 2022Replantation is the ideal treatment in traumatic scalp defects to provide immediate coverage with restoration of hair-bearing skin. However, data are limited to case...
BACKGROUND
Replantation is the ideal treatment in traumatic scalp defects to provide immediate coverage with restoration of hair-bearing skin. However, data are limited to case reports and small case series. Comprehensive analysis of techniques and outcomes is not available. Our aim was to systematically analyze the available literature to better understand management and postoperative outcomes of patients undergoing scalp replantation.
METHODS
A systematic review of the PubMed, Cochrane, and EBSCO databases was performed in October 2019. Search terms included "replantation," "replant," "revascularized," "revascularization," "avulsion," and "scalp." Only papers reporting microvascular replantation of completely avulsed scalps, including case reports, were included. Review articles, non-English language articles, articles discussing nonreplant coverage, incomplete scalp avulsions, and articles discussing delayed scalp replantation were excluded. Data extracted included demographics, percent of scalp affected, mechanism, operative technique, and postoperative outcomes. Statistical analysis was performed using Mann-Whitney U tests, Kruskal-Wallis, and chi-squared tests.
RESULTS
From a total of 704 initial results, 61 studies were included for analysis comprising 149 scalps. Complete survival was achieved in 54.7%, partial survival in 38.9%, and failure in 6.7%. Total ischemia time greater than 12 hours was associated with complete replant failure. Arterial anastomoses appeared to protect against complete loss. The number of venous repairs, proportion of venous-to-arterial repairs, use of vein grafts, thromboprophylaxis, or intraoperative complications did not affect outcomes. Patients required significant volumes of blood products, which was associated with partial success. Salvage rate after unplanned return to the operating room was 60.0%. Normal hair growth was achieved in all surviving native scalp tissue.
CONCLUSION
Scalp replantations, while technically challenging, are the ideal treatment for scalp avulsions. Fortunately, these have high rates of success. And as a focal point of a patient's appearance, this is invaluable in restoration of a sense of normalcy.
Topics: Anticoagulants; Humans; Microsurgery; Replantation; Scalp; Venous Thromboembolism
PubMed: 34010964
DOI: 10.1055/s-0041-1729876