scholarly journals Multiple Burr Hole as an Alternative Treatment for Large Scalp Defect

2021 ◽  
Vol 4 (1) ◽  
pp. 32
Author(s):  
Priscilla Valentin N ◽  
Iswinarno Doso Saputro
Keyword(s):  
Alternative Treatment ◽  
Burn Injury ◽  
Skin Grafting ◽  
Cranial Bone ◽  
Skull Bone ◽  
Flap Coverage ◽  
Scalp Defects ◽  
Scalp Defect ◽  
Serious Injury ◽  
Burr Holes

Background: Scalp defect with exposed bones is a serious injury that is often occurred after electrical burn injury. The coverage treatment may vary from local flap to free flap. Coverage becomes a major problem when flaps fails or is contraindicated and resulting in further morbidity. In this paper we report 1 patient with large scalp defect after electrical burn injury.Methods : In this study, we report 1 patient with large scalp defect after electrical burn, which treated in our department. Fourteen days after the electrical burn injury, surgical debridement was done by the plastic surgeon, and multiple burr holes were made by the neurosurgeon in the nonviable bone. The distance between each burr holes was 15 mm. The defect was keep moist with absorbent. The scalp defects were treated with soft tissue debridement every 3 days in the policlinics to keep the wound presented viable. To date, the wound already treated for 90 days.Results : The granulation tissue appears in between the burr holes within 14 days. After the defect was covered with granulation tissues, a further closure such as skin graft application was necessary. No postoperative infection, osteomyelitis, or cranial bone sequestration was reported in this case.Conclusions: Multiple cranial burr holes can be chosen as an alternative treatment for large scalp defect. These technique, allow the formation of a vascular bed suitable for skin grafting. This technique is safe, swift and effective for cases of extensive exposure for the skull bone expose of the periosteum following trauma.

scholarly journals Sternocleidomastoid Myocutaneous Flap for Scalp Reconstruction

2019 ◽  
Vol 5 ◽  
pp. 2513826X1982879
Author(s):  
Jin Woo Kim ◽  
Do Hun Kim
Keyword(s):  
Chronic Inflammation ◽  
Primary Closure ◽  
Myocutaneous Flap ◽  
Free Tissue Transfer ◽  
Skin Grafting ◽  
Pedicled Flap ◽  
Scalp Reconstruction ◽  
Scalp Defects ◽  
Scalp Defect ◽  
Defect Area

Scalp defects may occur due to various causes, such as head trauma. For reconstruction of the defect, a primary closure process, skin grafting, or local flap use are the foremost choices when the defect area is not wide. However, repair is difficult when the wound condition further deteriorates due to chronic inflammation. In this condition, free tissue transfer or a pedicled flap is required to restore normal blood supply. The sternocleidomastoid (SCM) flap is conventionally raised as a superiorly or inferiorly based pedicled flap, easily harvested to rectify a nearby scalp defect; additionally, it may either be muscular or myocutaneous. This report describes a case of successful use of the SCM flap for scalp reconstruction, raised as a superiorly based myocutaneous flap.

scholarly journals Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Lu ◽  
Ke-Chung Chang ◽  
Che-Ning Chang ◽  
Dun-Hao Chang
Keyword(s):  
Skin Graft ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Salvage Procedure ◽  
Primary Defect ◽  
Scalp Defects ◽  
Thickness Skin ◽  
Scalp Defect ◽  
Secondary Defect

Abstract Background Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The “crane principle” is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Decades ago, it was commonly used for forehead scalp defects, but this useful technique has been seldom reported on in recent years due to the improvement of microsurgical techniques. Previous reports mainly used the crane principle for the primary defects, and here we present a case with its coincidental application to deal with a complication of a secondary defect. Case report We present a case of a 75-year-old female patient with a temporoparietal scalp squamous cell carcinoma (SCC). After tumor excision, the primary defect was reconstructed using a transposition flap and the donor site was covered by a split-thickness skin graft (STSG). Postoperatively, the occipital skin graft was partially lost resulting in skull bone exposure. For this secondary defect, we applied the crane principle to the previously rotated flap as a salvage procedure and skin grafting to the original tumor location covered by a viable galea fascia in 1.5 months. Both the flap and skin graft healed uneventfully. Conclusions Currently, the crane principle is a little-used technique because of the familiarity of microsurgery. Nevertheless, the concept is still useful in selected cases, especially for the management of previous flap complications.

scholarly journals Scalp Reconstruction Following High Voltage Electric Burn

2014 ◽  
Vol 3 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Md Zakir Hossain ◽  
Bidhan Sarker ◽  
Lutfar Kader Lenin ◽  
Ayesha Hanna ◽  
Limon Kumar Dhar
Keyword(s):  
Plastic Surgery ◽  
High Voltage ◽  
Skin Grafting ◽  
College Hospital ◽  
Transposition Flap ◽  
Reconstructive Procedures ◽  
Rotation Flap ◽  
Medical College ◽  
Scalp Reconstruction ◽  
Scalp Defects

Background: Scalp reconstruction following high voltage electric burn can be challenging. A useful Reconstructive algorithm is lacking. The purpose of this study was to evaluate our experience and to identify an appropriate reconstructive strategy. Methodology: This was a prospective observational study, conducted in the Burn unit of Dhaka Medical College Hospital & Department of Burn & Plastic Surgery,Sir Salimullah Medical College & Mitford Hospital over a period of five years. Reconstructive procedures, independent factors and outcomes were evaluated. A total of 7 procedures were performed in 30 patients. Techniques for reconstruction included skin grafting, outer table drilling & skin grafting, Bipedicle flap, Single rotation flap, Double opposing rotation flap, Transposition flap, Tissue expansion & primary closure. Conclusion: Important tenets for successful management of scalp defects are durable coverage, adequate debridement, preservation of blood supply, and proper wound drainage. Local scalp flaps with skin grafts remain the mainstay of reconstruction in most instances. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18251 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 49-52

scholarly journals Minimally Invasive Technologies for Treatment of HTS and Keloids: Fractional Laser

2020 ◽  
pp. 279-285
Author(s):  
M. Tretti Clementoni ◽  
E. Azzopardi
Keyword(s):  
Minimally Invasive ◽  
Burn Injury ◽  
State Of The Art ◽  
Skin Grafting ◽  
Complex Problem ◽  
Fractional Laser ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Insight Into

AbstractThis chapter presents a state-of-the-art insight into the use of fractional laser for the management of this complex problem. In particular, we focus on the management of complex scars such as those occurring post-burn injury and split-thickness skin grafting.

Skin Grafting for Full-Thickness Burn Injury

1980 ◽  
Vol 80 (11) ◽  
pp. 2000-2005
Author(s):  
Maribeth Wooldridge ◽  
Judith A. Surveyer
Keyword(s):  
Burn Injury ◽  
Skin Grafting ◽  
Full Thickness

Application and Experience of Various Reconstructive Procedures in Scalp Defects

2021 ◽  
Vol 15 (6) ◽  
pp. 1472-1474
Author(s):  
K. Q. Shaikh ◽  
A. Q. Shaikh ◽  
Z. H. Tunio ◽  
R. A. Jhatiyal ◽  
M. K. Mugria ◽  
...  
Keyword(s):  
Malignant Tumour ◽  
Cross Sectional ◽  
Reconstructive Procedures ◽  
Scalp Defects ◽  
Scalp Defect ◽  
Co Morbidity ◽  
Plastic Reconstructive Surgery ◽  
History Of ◽  
Electric Injury

Aim: To evaluate the outcome of various reconstructive procedures in scalp defects. Study Design: Cross sectional descriptive study. Place and Duration of Study: Department of Plastic/Reconstructive Surgery & Burns, LUMHS Jamshoro from 1st January 2018 to 31st December 2020. Methodology: Thirty patients of scalp wounds were admitted through outpatient and casualty departments. The patients were diagnosed by pre-operative workup and on clinical parameters were included. The patients unfit for general anaesthesia, patients having associated skin pathology, patients with history of allergic reactions and patients having any poorly controlled systemic co-morbidity like diabetes and hypertension were excluded. Results: Twenty two (73.33%) were males and 8 (26.66%) were females with mean age of 38.98±8.25 years. Scalp defect was due to trauma in46.66%, electric injury 23.33%, benign lesions 16.66%, malignant tumour 3.33%, Infection 3.33%, haemangioma and pigmented nevus 3.33%. Follow up duration was 42.34±7.83 weeks. Conclusion: Primary closure remained the mainstay of our treatments hence proved that simplest reconstruction should be used whenever possible to provide the most functional and aesthetic scalp reconstruction, with the least amount of complexity. Key Words: Scalp, Reconstructive surgical procedure, Graft, Flap

Cyanoacrylate Nail Glue and the Pajama Catalyst

2020 ◽  
Vol 41 (6) ◽  
pp. 1306-1308
Author(s):  
Harvey Rich ◽  
Jonathan J Cubitt
Keyword(s):  
Healthcare Workers ◽  
Burn Injury ◽  
Exothermic Reaction ◽  
Natural Fibers ◽  
Skin Grafting ◽  
Young Lady ◽  
Burn Injuries ◽  
Surgical Team ◽  
The Public ◽  
Online Retailers

Abstract Nail glues are routinely used for the application of false nails and are readily available for unrestricted purchase from highstreet and online retailers. We present the case of a young lady who accidentally spilled her nail glue on to her cotton pajama trouser leg setting off a violent exothermic reaction that resulted in a full-thickness burn injury to her foot. She ultimately went on to require surgical debridement and skin grafting. We intend to remind both healthcare workers and members of the public that while nail glue alone in contact with the skin is relatively harmless, contact together with natural fibers such as cotton clothing produces a dangerous chemical reaction, which is too often underestimated and can lead to serious burn injuries. Our patient and the surgical team agree that more must be done to raise awareness of the risks these products pose, and retailers must ensure consumers are responsibly informed.

Too Hot to Handle? Full-Thickness Burn Injury in a Child Caused by Cyanoacrylate Glue and Cotton—A Case Report and Experimental Study

2020 ◽  
Author(s):  
Madeleine Jacques ◽  
Sonia Tran ◽  
Monique Bertinetti ◽  
Andrew J A Holland
Keyword(s):  
Case Report ◽  
Burn Injury ◽  
Exothermic Reaction ◽  
Skin Grafting ◽  
Radiant Heat ◽  
Maximum Temperature ◽  
Full Thickness ◽  
Cyanoacrylate Glue ◽  
Potential Harm ◽  
Education And Awareness

Abstract Domestic superglue (cyanoacrylate) in the hands of children can have devastating consequences, especially when cotton clothing is involved. When cotton comes into contact with cyanoacrylate, an intense exothermic reaction occurs, creating temperatures high enough to cause significant thermal injury. A literature review found 16 such cases of burns documented (2 adult and 14 pediatric). This article presents a case report of a 4-year-old child sustaining a full-thickness burn injury to her leg requiring skin grafting when superglue was spilt onto cotton pants. She was sitting near a fan heater at the time. An experiment was conducted to replicate the exothermic reaction between superglue and cotton and to determine if the addition of radiant heat would have any significant effect. The maximum temperature reached with one 3-g tube of superglue onto cotton pyjamas was 91°C (196°F) and occurred approximately 90 seconds postapplication. It took more than 3 minutes for the temperature to cool below 40°C (104°F). The addition of radiant heat from a fan heater placed 60 cm from the clothing found that the temperature peak was similarly reached and cooled, but the temperature did not reduce below 52°C (126°F) for over 20 minutes, proving that potential harm may be amplified if first aid is not appropriately sought. Product labeling and the knowledge of potential harm from such mechanism of injury remain inadequate. It is hoped that the reporting of this case contributes to an increase in public education and awareness of such dangers and may contribute to preventing avoidable future incidences.

Burns

2018 ◽  
Author(s):  
Sanjay Bhananker ◽  
Paul Bhalla
Keyword(s):  
Burn Injury ◽  
Carbon Monoxide Poisoning ◽  
Fluid Management ◽  
Skin Grafting ◽  
The Body ◽  
Smoke Inhalation ◽  
Accurate Estimation ◽  
Burn Victims ◽  
Anesthesia Providers ◽  
Catabolic State

Burns injuries are a leading cause of morbidity and mortality in children. A significant burn injury affects every major organ system of the body. Initial management focuses on resuscitation along the ABCDE approach, with particular vigilance for the possibility of airway burn causing progressive edema and narrowing. Smoke inhalation is associated with carbon monoxide poisoning and possible cyanide toxicity. Fluid management depends on accurate estimation on the extent of the burn and use of a formula to calculate infusion rate, with careful monitoring of end-organ perfusion. Significant burn injuries are associated with hypermetabolic changes and a catabolic state, and burn victims are at high risk of developing sepsis. Treatment of a burn injury with debridement and skin grafting can involve multiple visits to the operating room with frequent need for sedation and anesthesia. Providers need a thorough understanding of potential anesthetic issues in burn-injured pediatric patients.

scholarly journals A paradigm shift in practice—the benefits of early active wound temporisation rather than early skin grafting after burn eschar excision

2020 ◽  
Vol 48 (2) ◽  
pp. 93-100
Author(s):  
John E Greenwood
Keyword(s):  
Skin Graft ◽  
Paradigm Shift ◽  
Burn Injury ◽  
Donor Site ◽  
Total Body Surface Area ◽  
Skin Grafting ◽  
Graft Harvest ◽  
Major Burn ◽  
Early Closure ◽  
Total Body

After major burn injury, once survival is achieved by the immediate excision of all deep burn eschar, we are faced with a patient who is often physiologically well but with very extensive wounds. While very early grafting yields excellent results after the excision of small burns, it is not possible to achieve the same results once the wound size exceeds the available donor site. In patients where 50%–100% of the total body surface area is wound, we rely on serial skin graft harvest, from finite donor site resources, and the massive expansion of those harvested grafts to effect healing. The result is frequently disabling and dysaesthetic. Temporisation of the wounds both passively, with cadaver allograft, and actively, with dermal scaffolds, has been successfully employed to ameliorate some of the problems caused by our inability to definitively close wounds early. Recent advances in technology have demonstrated that superior functional and cosmetic outcomes can be achieved in actively temporised areas even when compared with definitive early closure with skin graft. This has several beneficial implications for both patient and surgeon, affecting the timing of definitive wound closure and creating a paradigm shift in the care of the burned patient.

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