title: Severe electric burn of the skull.
abstract: We report a case of severe injury of the scalp and skull caused by high tension electric current. The patient developed tetraplegia. The surgical steps undertaken are also described. We used two consecutive free flaps which failed 5 days after each operation. We discuss the possible causes for flap failure, which we think was due to damaged receptor vessels. The wound was closed after expanding the adjacent scalp. Scalp expansion was an uneventful procedure, however infection of the cavity developed. We overcame this problem by an aggressive approach (cavity irrigation, daily expansion and systemic antibiotherapy). The use of a synthetic mesh to avoid cerebral herniation through the bone defect is also described.
authors.affiliation: Service of Plastic Surgery, Hospital Clinic, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Benito-Ruiz
authors.forename: P
authors.initials: P
authors.lastname: Baena-Montilla
authors.forename: A
authors.initials: A
authors.lastname: Navarro-Monzonís
authors.forename: E
authors.initials: E
authors.lastname: Bonanad
authors.forename: P
authors.initials: P
authors.lastname: Cavadas
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002058:Burns, Electric / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D012535:Scalp; D012886:Skull; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure