Preservation of nonviable cranial bone after class IV electrical burns.
BACKGROUND
It has been suggested that preservation of nonviable cranial bone is possible in some selected cases in the absence of infection.


METHODS
A series of ten male patients, mean age 29 +/- 7 with severe electrical scalp burns and nonviable cranial bone were managed conservatively. The patients were treated initially by soft-tissue debridement until the wound presented viable, clean margins. At 22 +/- 6 days after the burn, multiple burr holes were made in the nonviable bone, and the defect immediately covered with a well-vascularized scalp flap. Each patient's progress was documented during the hospital stay and during the follow-up for at least one year.


RESULTS
The multiple burr holes filled with fibrous tissue and the contour of the skull was maintained in all 10 patients making the need of a secondary cranioplasty unnecessary. No postoperative infection, osteomyelitis, or cranial bone sequestration occurred.


CONCLUSIONS
Even with moderately delayed management of contaminated electrical burns, partial excision of the necrotic bone with burr holes and flap coverage appears to be adequate.
Cruz
Norma I
NI
Plastic Surgery Division, University of Puerto Rico School of Medicine, San Juan. normacruz01@prtc.net
Saavedra
Fanor M
FM
D000328:Adult; D002058:Burns, Electric / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D012720:Severity of Illness Index; D012886:Skull / Q000293:injuries* / Q000601:surgery*