Succesful reattachiment of entire scalp and half face skin pulled off by horrific accident

16/12/2019 09:25

Doctors of Viet Duc University Hospital have successfully reattached the largest skin for the patient was pulled off entire scalp and half face.

 

The patient – Do Thi P., female, 38 years old, living in Hanoi, worker, had her scalp pulled off after horrific accident that wrapped her hair in an iron lace machine at 8:30 on November 2^nd, 2019. The patient was provided the first aid at the local hospital and transferred to Viet Duc University Hospital on the same day.

 

“When admitting to the hospital, Ms. P. was alert but rapid PR, low BP, massive hemorrhage inspite of the thick bandage in the head. The scalp was kept in a plastic bag with ice over outside .” Dr. Nguyen Thi Thanh shared.

 

A quick consultation was conducted among first-aid team and specialists from Maxilofacial and Plastic surgery Department in order to assess the injury and patient’s condition. A micro-surgical emergency room was well prepared. The duration of operation was nearly 12 hours and ended at dawn on November 3^rd, 2019. Even not on duty, many doctors such as Dr. Tran Xuan Thach and others were deployed to join the operation.

 

Assoc. Prof. Dr. Nguyen Hong Ha, Head of Maxillofacial Surgery – Plastic Surgery Department said: “With the strength in micro-surgery, Viet Duc University Hospital is one of the first medical facilities in Vietnam to perform the re-attachment of torn-off scalp successfully. However, this is probably the most extensive case with entire scalp that was torn off from the eyelids on both sides to the nape and shattered into many fragments connected by small skin bridges that will severely interfere with reperfusion after reconstructing blood vessels. With these injuries, the first aid is very important. Good resuscitation, hemostasis, proper preservation and timely transferral of patients to an appropriate surgical facility as soon as possible could contribute to the success of surgery”.

Dr. Vu Trung Truc MA., Deputy Head of the Maxillofacial – Plastic Surgery Department, who directly performed the operation, said: “This was a complex surgery conducting nearly 12 hours. Therefore, it is necessary to have sufficient human resource and material and smooth and standardized cooperation among many specialists. In addition, not only the scalp was peeled off, the wound was also extended through the cheeks down to the chin and flipped the entire one side of the face causing facial nerve damage and parotid salivary glands. Those injuries prolonged the surgery time even several hours. Dozens of liters of blood, blood products and fluids were used during the operation. The reconstruction of blood vessels was also difficult because temporal blood vessels on both sides were crushed. Doctors have to take veins on the instep and toes to make the connection from the front of the ear to the top of the head. The smallest blood vessel that was grafted here is the supra-orbital veins, which was only about 0.7 mm, smaller than the tip of a toothpick with extra-thin thread of 11/0”.

 

Now, two weeks after surgery, the patient is stable and able to eat and walk normally. The re-attached scalp were adapted well and hair has started to grow back. Workers, in general, especially those working near machines with high risk of hair or clothe entanglement must strictly follow labor safety regulations to avoid accidents.