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Coronal approach

Closure

Skin closure
The use of a suction drain is optional. Flat drains are brought out through the scalp posterior to the coronal incision.
Finally the scalp is folded back and properly aligned into the original position.
The wet gauze and the hemostatic clips are removed stepwise and hemostasis is achieved. The scalp is then closed in two layers along the exposed wound edges.
For the galea/subcutaneous layer slow resorbing 2-0 sutures are used. The skin incision is closed with permanent skin sutures or surgical staples. Staples are preferred if the hair was not shaved.
The preauricular extension of the coronal incision is closed in layers.
Hair and skin are copiously rinsed to remove residual blood clots.
A compressive head dressing may be placed to prevent hematoma formation underneath the coronal flap. It should not be too tight, as periorbital edema will intensify with the scalp under tight pressure.
The scalp skin sutures/staples are removed 10 days postoperatively. Preauricular skin sutures are removed after 6 days.