American family physician
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The punch autograft method of hair transplantation has been the mainstay of hair replacement for 25 years. Recently, scalp reduction has emerged as an adjunctive procedure to eliminate bald areas. The procedure is done in the outpatient setting and has been extremely successful in cases of traumatic injury to the scalp, as well as congenital and scarring alopecia. Temporal transposition flaps of hair-bearing scalp should be carried out by surgeons with expert training.
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Chemotherapy-induced alopecia is now potentially preventable. Although scalp tourniquets and hypothermia are neither universally applicable nor always successful, they represent simple and relatively inexpensive methods for reducing hair loss. When successful, these techniques help maintain the patient's self-image and thereby diminish the devastating psychologic effects that accompany a diagnosis of cancer.
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Shock is a consequence of insufficient blood flow for adequate oxygenation at the cellular level. Early recognition of the signs permits prompt therapy to maintain the effective circulating volume before irreparable organ damage occurs. ⋯ Replacement of red blood cells may be required for acute blood loss of more than 25 percent of the patient's circulating volume. Adequate arterial PO2 is essential for maintaining cellular oxygenation.