First, what is scalp hematoma|
Scalp hematoma due to blunt injuries to the scalp caused by appearing in the relationship between the classification levels of the scalp (Figure 4-1).
(A) subcutaneous hematoma: a result of the subcutaneous tissue and skin layer and subgaleal layer connection between the close, so in this layer of the hematoma is not easy to spread and range than its predecessor. Hematoma, soft tissue swelling, a sense of touch of a depression, with depressed fractures easily confused, and sometimes need skull X-ray examination to clear.
(B) subgaleal hematoma: from the layer of small artery or blood vessel rupture caused by lead. Galeal lower loose, easy to expand or even hematoma spread to the entire subgaleal lower, with up to several hundred milliliters of blood can be.
(C) the subperiosteal hematoma: more common in the skull due to blunt injury occurs due to deformation or fracture. Such as infant and adult table tennis-like depression fracture linear skull fracture often complicated by such a hematoma. As the periosteum at the suture attached to a solid, it often does not exceed the scope of hematoma suture. In infants and young children, old hematoma with peripheral calcification or ossification of the periosteum can be, and even the formation of bone cysts containing old blood.
Treatment of scalp hematoma is generally small, no special treatment, after 1 to 2 weeks more to self-absorption. Often require a large hematoma puncture in addition to both local compression bandage, by one or several treatments may be more. Puncture therapy, or continued increases Needless hematoma, can be cut to remove the hematoma and bleeding. fracture of the skull combined subperiosteal hematoma, pay attention to the possibility of concurrent intracranial hematoma. Who have been infected hematoma required incision and drainage.
Second, the scalp laceration
Scalp laceration by a sharp or blunt multiple injuries. Gap size, the depth varies, neat wound edge or irregular, sometimes with skin contusion or defect, because the scalp rich in blood vessels, blood vessel rupture is not easy to be self-closing, even if small bleeding wounds are more serious, or even shock.
Emergency dissecting pressure bandage to stop bleeding. Early debridement, the wound to remove foreign body, bleeding, intraoperative attention to whether the skull fracture and meningeal suture the wound after injury. Of a subcutaneous scalp tissue defects underwent lysis or flap repair and other methods. For 2 to 3 days after injury over the wound, but also Yiqing record, part of the suture, and additional drainage.
Third, the scalp avulsion
More involved because of the scalp caused by the strong, such as rotating machinery involved in hair identified in the scalp or the entire part of the lower self-subgaleal or subperiosteal avulsion, heavy damage, bleeding, shock-prone.
First aid, cover the wound with sterile dressing, pressure bandage to stop bleeding; while avulsion of the scalp with sterile gauze wrap spare, for the debridement within 12 hours. Entire scalp avulsion, viable small vascular anastomosis, scalp replantation, or avulsion of the scalp or made into full-thickness skin graft in the replantation. Small avulsion of the scalp can be transferred. Large areas of the scalp, skull defect and meningeal blood vessels of the omentum can be covered with wounds, until the growth of granulation tissue after skin grafting. Wound infection or infected skin graft failure as a general wound management. After the exposed area in the skull, for every 1 cm depth of baffle drilling or cutting the skull plate removed, until the growth of granulation tissue after skin grafting.