TY - JOUR T1 - Severe traumatic scalp avulsion requiring an uncommon reconstruction: omental free tissue transfer flap JF - Trauma Surgery & Acute Care Open JO - Trauma Surg Acute Care Open DO - 10.1136/tsaco-2022-000895 VL - 7 IS - 1 SP - e000895 AU - Alyssa Catherine MacLean AU - Adil Ladak AU - Ryan Snelgrove AU - Haili Wang AU - Hollie Power AU - Nori L Bradley Y1 - 2022/03/01 UR - http://tsaco.bmj.com/content/7/1/e000895.abstract N2 - A 29-year-old woman presented to our level 1 trauma center following blunt head trauma from agricultural equipment. During advanced trauma life support assessment, secondary survey revealed a near-total scalp degloving injury, encompassing the forehead and circumferential scalp to the superior nuchal line (figure 1A). The avulsed scalp was severely damaged and fragmented, precluding immediate reimplantation. The patient underwent multiple operative debridements and diligent wound management with saline-soaked dressings, then negative pressure wound therapy once the wound base was clean. Despite elevation of local periosteal and temporalis muscle advancement flaps, incomplete calvarial coverage rendered primary skin graft reconstruction impossible. The patient continued to have exposed calvarium, necessitating vascularized soft tissue coverage1 (figure 1B).Figure 1 (A) Severe circumferential scalp avulsion injury on ATLS secondary survey in trauma bay. (B) Exposed calvarium persists despite multiple operative debridements and elevation of local advancement flaps. ATLS, advanced trauma life support.Burr the outer table of the calvarium, negative pressure wound therapy, then eventual split-thickness skin graftAnterolateral thigh free flap ± skin graftOmental free flap with split-thickness skin graftLatissimus … ER -