Management of Chronic Scalp Defect with Exposed Dura Mater Post Severe Electrical Burn: Case Report

Abstract

Multiple managements were introduced to treat skull defect due to high voltage electrical burns. The main objective of this article is to highlight the acute management in treating skull defect aiming to ensure healthy tissues and eliminate the risk of infection before proceeding into further indicated management. We report a case of a 28-year-old male, previously healthy with a history of high-voltage electrical burns due to a home incident in Algeria in 2019. Admitted two years later at Saint Louis Hospital Burn Unit with a skull defect and amputated big and second toes of the left foot. He was treated initially in a local hospital in Algeria, underwent two rotational flaps with multiples burr holes were made over the outer table of parietal region. He had multiple surgical debridement with serial dressing for one year. At the time of admission, the patient was complaining of uncovered scalp defect located over the parietal region with exposure of the external table and purulent discharge. Debridement and skin graft was performed as acute coverage, two months post-operation the defect was completely covered, satisfying healthy tissues were identified. Skin graft can be considered as one of the optimal managements for treating a scalp defect if there is any suspicion of underlying infection and collection or vascular issues before proceeding to preform further coverage as free flap.