Sandeep B1, Chang Chew1, Dr Kiran Narula1, Dr Satya Swaroop Tripati
1Fiona Stanely Hospital, Perth, Australia
Electrical contact burns are devastating. The contact burns usually occur in the limbs but can occur in other locations like scalp, abdomen, perineum etc. Scalp contact burns are quite commonly seen. We present our case series of 20 patients and their spectrum of presentation and management.
Materials and method
All cases of electric contact burns data were retrieved from 2013 to 2015 data registry. Scalp defect cases were analyzed.
20 patients scalp electric burns were treated during the time period of 2013 to 15. 18 were male and 2 were female patients. Mean age of presentation was 35.5 years. History of fall from height was there in 5 patients their scalp defect was addressed secondarily. Mean hospital stay during the admission for scalp defect were 38.4 days in acute setting, 12 days in outpatient admission patients. Skin only involvement was seen in 2cases, skin + periosteum in 2 cases, skin+periosteum + anterior table of skull in 12, skin + 2 tables of skull in 2 cases, skin + full thickness skull + pus underlying with dural involvement in 2cases. After debridement cover was provided by local flaps in 16 cases, 2 patient underwent extracorporeal RAFF, 2 patients required free flap (1-RAFF 1- LD muscle), one case grafting on dura followed by tissue expansion and flap cover was done. Bone defect later requires split calvarial bone reconstruction.
Electric contact burn of scalp presents in myriad ways with different depth of involvement from skin, calvarium, dura, brain matter. This warrants debridement of devitalized anterior or both anterior and posterior cortex of skull, sometimes requiring pus drainage. Coverage of the defect is done with either locoregional flap or if local options absent then coverage is given by free flap.
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