In the severest forms of scalp-injuries, such as avulsion of the
scalp from the entangling of the hair in machinery, skin-grafting
or replantation is of particular value. Ashhurst reports a case
which he considers the severest case of scalp-wound that he had
ever seen, followed by recovery. The patient was a girl of
fifteen, an operative in a cotton-mill, who was caught by her
hair between two rollers which were revolving in opposite
directions; her scalp being thus, as it were, squeezed off from
her head, forming a large horseshoe flap. The linear extent of
the wound was 14 inches, the distance between the two extremities
being but four inches. This large flap was thrown backward, like
the lid of a box, the skull being denuded of its pericranium for
the space of 2 1/2 by one inch in extent. The anterior temporal
artery was divided and bled profusely, and when admitted to the
hospital the patient was extremely depressed by shock and
hemorrhage. A ligature was applied to the bleeding vessel, and
after it had been gently but carefully cleansed the flap was
replaced and held in place with gauze and collodion dressing. A
large compress soaked in warm olive oil was then placed over the
scalp, covered with oiled silk and with a recurrent bandage.
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