Abstract: Objective To explore the emergency management of total scalp avulsion with microsurgical replantation. Methods From July 2009 to December 2014, 6 cases with total scalp avulsion were treated with microsurgical replantation. Initial management in the emergency department included correction of hemorrhagic shock with early blood transfusion, intravenous rehydration and wound compression after rapid physical examination. A compound trauma and preoperative workup prior to replantation was performed to exclude any associated life-threatening injuries. Results The scalp of 6 cases was survived well, good appearance and function of the completely avulsed tissues and organs were achieved in all the cases. Conclusion Successful replantation can achieve the best esthetic and functional results when compared with other procedures. In addition, preoperative evaluation and preparation in the emergency department are considered to be an important part of the successful salvage of the avulsed scalp.

Key words: Emergency management, Microsurgery, Replantation, Scalp avulsion