[hermantheshocker]

The patient suffered a massive avulsive scalp injury. Centrally, pericranium is missing while anteriorly and posteriorly, pericranium is intact. Intact peri* cranium can support a skin graft, whereas bare bone cannot. The outer cortex of the central calvarial bone is removed with a cutting burr down to bleeding diploic bone. The vascularity of this bone is a receptive donor site for a split thickness skin graft. Several weeks s/p reconstruction of the scalp wound with medium split thickness skin grafts. Take is excellent. Compared with native scalp, skin grafts do not withstand trauma as well, as can be seen here where areas of the graft have broken down.







Graft survival depends on the microvasculature of the recipient site and contact between the donor site and the graft. Initially, skin grafts derive nutrition from the nutrient*rich plasma at the recently injured reci*pient site—a process called imbibition. After 24 hours, inosculation begins. This is a process marked by the cross*connection of graft and recipient site vessels. After 3 days, neovascularization begins causing the graft to appear hyperemic from days 3–7, with eventual lightening over the following 4–6 weeks.





Any accumulation of fluid such as hematoma or seroma results in a barrier between the graft and the wound bed, preventing diffusion to the graft, vascular ingrowth, and failure of graft take. Local recipient site factors that may decrease vascularity at the recipient site include infection, prior scar, previous irradiation, or exposed tissue with poor vascularity such as cartilage, tendon, or bone. To improve graft take to the bone, a cutting burr may be used to remove the outer cortex to expose the more vascular medullary bone which is more receptive for grafting.

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[corpsehands]

Hope he likes hats.

[ride]

Pickin' scabs, all day, every day.

[icehole]

on the bright side, he doesn't need to buy shampoo and pomade for life

[Sadisticfucker]

So this is not some kind of third world hair transplant treatment then ?