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Management of Complex Scalp Injuries 

Management of Complex Scalp Injuries
Chapter:
Management of Complex Scalp Injuries
Author(s):

Thana N. Theofanis

and Patrick Greaney

DOI:
10.1093/med/9780190936259.003.0020
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date: 25 May 2022

Complex scalp wounds require an understanding of basic anatomy and a broad knowledge of options for surgical repair. The scalp is comprised of five layers: skin, subcutaneous fat, galea aponeurotica, loose areolar tissue, and pericranium. The vascular supply is provided from vessels branching primarily off the external carotid artery. Sensation is provided by the trigeminal and C2–C3 nerves. A surgical team should evaluate all full-thickness and complex scalp lacerations, especially those associated with underlying skull fractures. Complications include wound dehiscence and infection. Clinicians must remain extremely vigilant in following these patients because an infection can lead to underlying osteomyelitis of the skull, meningitis, or subdural empyema. Often, multiple surgical teams may be involved, and a planned stepwise approach may provide the best outcome for the patient.

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