Successful Microsurgical Replantation of Scalp Amputation Using Medicinal and Chemical Leech Therapy: A Case Report

Abstract

Scalp amputation is a very rare occurrence worldwide. In particular, replantation failure may occur from venous congestion, which represents a major complication of replantation. Accordingly, this study reports on a scalp amputation case with successful replantation treatment using medicinal and chemical leech therapy. On November 11, 2017, a 47-year-old female patient experienced a complete amputation injury starting from the top of the nose involving the total scalp by rolling machine that packs laundry. Severe venous congestion was controlled by medicinal leech therapy performed six times a day and chemical leech therapy (subcutaneous low-molecular-weight heparin injection) three times a day for 10 days. Approximately 85% of the scalp was replanted, and hair growth was confirmed. The basic concept of replantation surgery, “replace tissue with like tissue,” makes replacement impossible with tissues other than the hair-bearing scalp. Accordingly, the authors present a case of successful replantation with both medicinal and chemical leech therapy.