First, scalp injury 1, scalp anatomy The scalp is divided into 5 layers, namely the epidermis, subcutaneous and capillary tendon membrane and other 3 layers bonded into a layer. Among them there are blood vessels, not easy to contract, easy to bleed after injury, subcapsular tendon membrane cavity for a potential void, the entire subscalp even into a void. The periosteum is bonded to the bone at the suture, and the rest is covered on the outer surface of the skull. 2, the type of scalp injury and its rescue measures (1) abrasions: superficial injuries or local bleeding can be pressure to stop bleeding, wound disinfection treatment and bandaging can be. (2) contusion laceration: often involving the whole layer of the scalp, bleeding more, before reopening should be cut around the hair, local anesthesia, after washing with sterile soap and water, then saline rinse, remove foreign bodies, disinfection and suture the whole layer. The tissue should be preserved as much as possible when expanding the wound, because the scalp has a good blood supply, multiple lacerations or thin strips of scalp can also be sutured and still heal. The whole body is injected with antimicrobial and tetanus antiserum. (3) Hematoma: According to the clinical manifestations and pathological changes, it is divided into the following three types. (1) Subcutaneous hematoma: it is a small hard mass with pressure pain and does not require special treatment. (2) subcapsular hematoma: common in children, huge hematoma can be extracted under strict sterilization, then the whole head bandage compression to stop bleeding; hematoma recurrence, the need to extract the blood again, at the same time should pay attention to whether the child has coagulation dysfunction, repeated extraction of blood may be complicated by anemia and blood volume deficiency; if repeated extraction of blood is ineffective, the hematoma still recurrence, should be under general anesthesia to cut the scalp of the pressure point, found bleeding point If the hematoma still recurs, the scalp should be incised under general anesthesia, the bleeding point should be found, and the hematoma should be stopped by electrocoagulation, and all the blood and clots in the subcapsular space should be released, and the whole head should be bandaged with pressure. ③Submembranous hematoma, i.e., a huge hematoma confined to a piece of skull, is treated as subcapsular tendon hematoma. ④ avulsion injury: massive bleeding can cause shock, and treatment such as sedation, anti-shock and stopping active bleeding should be used at the scene, and scalp sutures or vascular clamp can be made at the bleeding point to clamp the bleeding point, and the completely avulsed scalp should be dried and refrigerated and sent to the hospital with the patient for scalp wound debridement, shaving and sterilizing the hair of the free scalp and sewing it to the original place, or suturing the thicker arteriovenous end of the tear. For small scalp defects, the suture can be reduced; for larger scalp defects with exposed skull, the scalp flap with tip can be transferred and sutured, i.e., the full flap can be taken from the periosteum at the donor skin and transferred to the exposed part of the skull with tip; if there is still periosteum on the skull surface of the donor skin, or if there is still periosteum and other tissues on the skull surface after trauma, the full flap taken from the abdomen or lower extremity can be directly implanted at the scalp defect; for large exposed skull, the flap cannot be If the flap cannot be transferred, it can be drilled at intervals on the skull to reach the plate barrier, and the granulation can be grown from the bone cancellous of the plate barrier, which can cover all the exposed skull in a few weeks to a few months. A full layer of skin is then implanted on the surface of the granulation. The scalp is rich in blood supply and the skin graft can be viable even if the granulation surface is mildly infected.