Avulsion of the scalp treated by microvascular repair: the use of leeches for post-operative decongestion.

A 28-year-old fitter and turner was scalped at work. The scalp was avulsed from the nuchal area to the eyebrows in one piece. It was successfully replanted by microvascular surgery. Leeches were used to decongest the flap when venous drainage appeared inadequate during the first week. Only a small part of the flap eventually failed to survive and normal hair growth returned in all other areas.