Provider Prepared’s Weekly Pearl of Wound Wisdom #24 Gashing Galea!
Assessment of scalp lacerations should also include assessment of all of the deep tissues. The galea is the connective tissue layer against the bone. This needs to be assessed to determine if there is presence of a galeal laceration. Lacerations of the galea larger than 0.5 cm should be repaired. Literature recommends using 3-0 or 4-0 absorbable suture material in the galea.
Repair of the galea helps prevent development of subgaleal infections, and subgaleal hematoma. Repairing galea lacerations also protects anchoring of the frontalis muscle, which has cosmetic implications.
Hollander, JU et al. Assessment and management of scalp lacerations. UpToDate February 2018.
This patient’s wound did involve the galea. A complex three layer repair was performed with excellent cosmetic outcome.
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Nathan Whittaker, MD
- Brandon Durfee