Reconstruction of scalp defects in electrical burns: Challenges and options

Introduction: The defects of the scalp and calvarium pose a potential threat to the underlying brain. These defects may result from trauma, thermal or electrical burns, resection of benign or malignant tumors, infections, osteoradionecrosis, or congenital lesions. Aims and Objectives: Analysis of various scalp defects and their management. Methods and materials: A total of 94 patients were included in the study from 2005-2014. Sixty four patients were in the retrospective group and thirty patients were in the prospective group. Results: Majority of the patients in our study were young and middle age group and this group of patients were mostly affected by bear mauls, electrical burns or vehicular accidents. Commonest form of reconstruction in scalp defects was grafting followed by flap cover and expanders. Conclusion: Scalp and calvarial defects are caused by wide variety of aetiologies but bear maul form a significant proportion of patients in our series and more than 40% of free flaps in our series were done for these bear maul defects.This depicts the severity of injury by bear mauls, which takes a significant portion of our time and effort to deal and manage these patients.

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Reconstruction of Post-Electrical Burn Scalp Defect with Exposed Bone: A Case Report

10.31487/j.jscr.2020.02.09 ◽

2020 ◽

pp. 1-3

Author(s):

Rafaela Pais Serras ◽

Maria Manuel Mendes ◽

Pedro Martins ◽

Rafaela Pais Serras ◽

Ruben Coelho

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Transposition Flap ◽

Below The Knee ◽

Scalp Defects ◽

Reconstructive Ladder ◽

Degree Burn ◽

Scalp Defect ◽

Exposed Bone ◽

Electrical Burns

Introduction: Electrical burns are potentially devastating injuries and most often occur at the workplace. Scalp defects following electrical burns are a rare occurrence and usually present as a reconstructive challenge. Case Presentation: Male, 31 years old, suffered a high voltage electrical burn at work that resulted in a scalp defect with exposed bone and a third degree burn in the left leg and foot complicated by a compartment syndrome, which needed an emergent fasciotomy and later an amputation below the knee. The scalp defect was covered by a local transposition flap and a skin graft. At 3 months post-operatively flap survived completely with no necrosis or other complications. A satisfactory cosmesis and preservation of scalp contour were achieved. Conclusion: Reconstructive ladder must be respected in reconstruction of these rare and complex defects. Local transposition flaps, if available, are often an ideal choice for scalp reconstruction in that the adjacent tissue is of similar quality to the original defect tissue with a long-term durability, contour preservation, minimal donor site morbidity and an acceptable cosmesis.

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Coverage of Scalp Defects Following Contact Electrical Burns to the Head: A Clinical Series

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/s1535-1513(08)70105-x ◽

2007 ◽

Vol 2007 ◽

pp. 112-113

Author(s):

R.E. Salisbury

Keyword(s):

Scalp Defects ◽

Clinical Series ◽

Electrical Burns

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Coverage of scalp defects following contact electrical burns to the head: A clinical series

Burns ◽

10.1016/j.burns.2005.08.010 ◽

2006 ◽

Vol 32 (2) ◽

pp. 201-207 ◽

Cited By ~ 15

Author(s):

Cemil Dalay ◽

Erol Kesiktas ◽

Metin Yavuz ◽

Gokhan Ozerdem ◽

Sabri Acarturk

Keyword(s):

Scalp Defects ◽

Clinical Series ◽

Electrical Burns

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Oral Splint Therapy to Manage Electrical Burns of the Mouth in Children

Clinics in Plastic Surgery ◽

10.1016/s0094-1298(20)31742-9 ◽

1984 ◽

Vol 11 (4) ◽

pp. 685-692 ◽

Cited By ~ 5

Author(s):

Charles S. Czerepak

Keyword(s):

Splint Therapy ◽

Electrical Burns

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28 Year-old electronic technician dies from electrical burns in Georgia, August 18, 1986.

10.26616/nioshface8731 ◽

1987 ◽

Keyword(s):

Electrical Burns

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

BMC Surgery ◽

10.1186/s12893-021-01056-y ◽

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.

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