Surgical Treatment of Electrical Burns of the Scalp and Skull

Worthen, Eugene F.

doi:10.1016/s0094-1298(20)30344-8

Cited by 6 publications

(8 citation statements)

References 17 publications

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“… 4 , 15 Myocutaneous flaps and microvascular approaches, along with the application of partial-thickness skin grafts, have facilitated the transposition of large tissue segments and allowed for the transfer of extensive tissue flaps from diverse origins, providing immediate coverage to prevent exposure of the dura mater or brain. 4 , 7 , 16 Although debridement was chosen, the degree and extent of tissue injury precluded the possibility of creating a flap or performing a graft. Moreover, it is crucial to ensure that no necrotic bone is retained at the injury site, as it could impede consolidation.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is crucial to ensure that no necrotic bone is retained at the injury site, as it could impede consolidation. 7 Consequently, we opted for trepanations, exposing the diploe, followed by daily sterile dressing with the aim of promoting the growth of vitalized tissue. This approach was chosen to keep the dura mater and brain unexposed, thus preventing the leakage of cerebrospinal fluid and minimizing the risk of infection.…”

Section: Discussionmentioning

confidence: 99%

“…The collective impact of these factors often requires a considerable number of surgical interventions, giving rise to associated complications. 2 , 7 , 8 , 10 …”

mentioning

confidence: 99%

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Electric burn of the skull: treatment by applying trepanations and wound dressing. Illustrative case

Georgeto,

Lehmann,

Antonucci

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Although electric injuries to human tissue are uncommon in contemporary times, their occurrence implies a high degree of morbidity and mortality. These are primarily attributed to the impact of electric current on cellular membranes, resulting in the disruption of ionic changes. OBSERVATIONS In this paper, the authors present the case of an electric burn on the skull in a 50-year-old male, treated by utilizing trepanation and daily sterile wound dressing. This approach differs from the conventional treatment involving tissue grafts. LESSONS Although the techniques utilized in this case are not commonly chosen as the initial treatment option, they have demonstrated effectiveness. Despite the absence of tissue flaps or grafts, satisfactory coverage of the skull cap was achieved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Electric burn of the skull: treatment by applying trepanations and wound dressing. Illustrative case

Georgeto,

Lehmann,

Antonucci

et al. 2024

Journal of Neurosurgery: Case Lessons

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“…The most commonly employed treatment strategy currently is early soft-tissue reconstruction, keeping the nonviable bone in situ and allowing it to vascularize from the overlying soft-tissue and underlying dura. [16][17][18][19][20] The devitalized bone is thought to act as an in-situ bone graft. 21 Making burr holes in the outer table may improve bone revascularization.…”

Section: Ementioning

confidence: 99%

“An Algorithm for Reconstruction of Electrical Injuries of the Scalp”

Khalid

Ahmed

Rabbani

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Electrical injuries of the scalp are a frequent occurrence in developing countries. Burns can be contact or conductive and result in extensive tissue damage. The authors present their experience with treatment of scalp and calvarial electrical injuries and propose a management algorithm. Methods: This was a retrospective cohort study comprising all patients with electrical injuries of the scalp treated at the authors’ center between January of 2010 and December of 2016. Noncontrast computed tomography scans were obtained to assess viability of the calvarium in patients who presented more than 2 weeks after injury. Single-stage débridement and reconstruction were performed. All nonviable soft tissue and bone was removed. Soft-tissue reconstruction was performed with skin grafts, local scalp flaps, pedicled trapezius flaps, and free flaps (anterolateral thigh, latissimus dorsi, and scapular). Cranioplasty was performed in a delayed manner with autologous bone grafts. Results: Over a 7-year period, a total of 52 patients underwent scalp reconstruction for high-voltage (44 patients) and low-voltage (eight patients) electrical injury. All patients underwent successful soft-tissue reconstruction. Osteomyelitis with draining sinuses developed in three patients; these patients underwent flap re-elevation and bone débridement, which resulted in a healed wound and stable reconstruction. Cranioplasty was performed with split calvarial grafts in two patients and split rib grafts in four patients. One patient underwent scalp tissue expansion for hair restoration. Conclusion: The authors propose an algorithm for reconstruction of electrical injuries of the scalp. Thorough débridement of the calvarium is the most important determinant of a successful outcome. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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“…It has become axiomatic to treat deep electrical burns of the scalp with split‐thickness skin grafts 1 . Since electrical burns enlarge with time, 2 sites as small as 1–2 cm are candidates for skin grafting 3 .…”

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confidence: 99%