Scalp defects

ABSTRACT

Scalp defects can result from trauma, tumors or infection. Whereas small defects can be closed with wide undermining and local flap coverage, large full thickness defects with exposed calvarium cannot be treated as such. Twenty patients with scalp defects were treated in the department of plastic and reconstructive surgery Mayo Hospital Lahore from 8.10.89 to 17.9.95. Fourteen [70%] of the patients were females. Thirteen [65%] belonged to rural areas. Trauma [65%], burns [25%], infection [5%] and tumors [5%] were the main causes of defects. Five [25%] patients [all females] had avulsion injury of the scalp. The size of defects varied from a minimum of 9 cm[2] to a maximum of 615 cm[2]. Nineteen [95%] had skin grafting with eighteen [90%] requiring split and one [5%] full thickness graft. Three [15%] required local flap rotation and seven [35%] bone chiselling. Majority [80%] of patients required two or less operations. The mean hospital stay was 38.5 days. There was only one mortality, which was related to burn injuries. It is concluded that bone chiselling followed by skin grafting is a safe and effective way of treating very large scalp defects and should be offered to patients where microsurgery is not feasible or available