Every vessel and nerve supplying the scalp was
destroyed, and the pericranium was torn off in three places, one
of the denuded spots measuring five by seven cm. and another five
by six cm. The neck flap of the wound fell away from the muscular
structures beneath it, exposing the trapezius muscle almost
one-half the distance to the shoulder blade. The right ear was
torn across in its lower third, and hung by the side of the neck
by a piece of skin less than five mm. wide. The exposed surface
of the wound measured 40 cm. from before back, and 34 cm. in
width near the temporal portion. The cranial sutures were
distinctly seen in several places, and only a few muscular fibers
of the temporal were left on each side. Hemorrhage was profuse
from the temporal, occipital, and posterior auricular arteries,
which were tied. The patient was seen three-quarters of an hour
after the injury, and the mangled scalp was thoroughly washed in
warm carbolized water, and stitched back in position, after the
hair was cut from the outer surface. Six weeks after the injury
suppuration was still free, and skin-grafting was commenced. In
all, 4800 grafts were used, the patient supplying at different
times 1800 small grafts.
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