RECONSTRUCTION OF FULL-THICKNESS SCALP DEFECT WITH INTEGRA AFTER ROAD TRAFFIC ACCIDENT: A CASE REPORT


Luqman A. Majid a, Vyan H. Mohammed Raouf a, Shakhawan S. Zorab a, and Mohammed S. Raheem a




Sulaimani Burn and Plastic surgery Hospital, Sulaimani, Kurdistan Region, Iraq. 



Submitted: 31/5/2021; Accepted: 11/11/2021; Published: 21/3/2022


ABSTRACT 


Introduction 

Reconstruction of lacerating scalp wound after a Road Traffic accident (RTA) with a sizeable full-thickness defect can pose a challenge for the surgeon. Various options are available for scalp wound reconstruction, including skin grafts and flaps but when the defect reaches the pericranium, the options become very limited


Case presentation 

We present the case with a sizeable full-thickness scalp defect and cranial bone abrasions after RTA. Our management plan was to cover the bone with a dermal regeneration matrix (INTEGRA). However, the challenge was the absence of the pericranium, which we overcame by using an electrical saw to abrade the bed and directly apply the (INTEGRA). It was taken very well in 19 days. The newly formed dermis was covered with a meshed split-thickness skin graft.


Discussion

We found that the combination of abrading a thin layer of an exposed skull bone after trauma with pericranial loss, direct application of dermal regeneration template (INTEGRA) and skin graft are safe and effective in managing large traumatic full-thickness scalp wounds with bare bone.


Conclusion

After four months follow up the good results of this case present a practical time-expedient operative approach to overcome the challenges faced by surgeons in dealing with sizeable traumatic scalp wounds that leave behind the unhealthy bare bone. 

Keywords:


KEYWORDS

INTEGRA, Scalp, Pericranium.