Effective Repair and Management of Severe Scalp Avulsion Sustained during Birth in an Extremely Low Birth Weight Infant

The physical forces experienced during childbirth can lead to various injuries, including head injuries, clavicular fractures, and peripheral nerve damage, particularly during vaginal deliveries. Among head injuries, scalp abrasions, caput succedaneum, and cephalohematomas are the most common; they are usually minor and often do not require treatment. However, more severe head injuries such as subgalealhemorrhages, depressed skull fractures, and intracranial hemorrhages are also relatively common and have serious consequences that necessitate urgent medical management.

This case report details the successful repair and management of a severe scalp avulsion and subsequent hemorrhagic shock in an extremely low birth weight infant.

An infant born at 26 weeks' gestation sustained a severe scalp avulsion during vaginal delivery, exposing the skull. The laceration extended 20 cm from the frontal temporal region along both sides of the head. The infant experienced hemorrhagic shock shortly after birth due to bleeding and was placed in a closed incubator for intensive care. Seven hours post-birth, the wound was sutured, quickly controlling the bleeding and allowing the infant to recover from hemorrhagic shock. A wet dressing was applied to the wound, which healed without necrosis.

Thus, the case highlighted the successful repair of severe scalp avulsion. Controlling bleeding and maintaining circulation are crucial for effective repair and management. In this case, suturing the wound and applying a wet dressing in a high-humidity environment contributed to the successful healing of the scalp.

Source: Takahashi S, Kanai Y, Miyazono Y, Hitaka D, Fujita Y, Shibuya Y, Takada H. Successful Repair and Management of Severe Scalp Avulsion Incurred during Birth in an Extremely Low Birth Weight Infant. Case Rep Pediatr. 2024 Sep 10;2024:8122801. doi: 10.1155/2024/8122801. PMID: 39290974; PMCID: PMC11407892.