FORMATION OF GRANULATION TISSUE BY DRILLING HOLES IN THE CRANIUM AFTER CHEMICAL SCALP BURNS: A CASE STUDY

Abstract

Although chemical burns constitute 3% to 5% of all burns, they are responsible for 30% of burn-related deaths. Chemical burns cause protein denaturation in physiological proteins by different mechanisms such as reduction, oxidation, corrosion, purification, salinization, and protoplasmic poisoning. Time is very important in the treatment of chemical burns. Chemical substances should be removed very quickly from the body. Chemical scalp burns (with bones) are a rare injury in clinical practice. In the case of scalp burns, including bones, it becomes an important problem when flab surgeries fail or cannot be performed. This study was planned to examine the formation of granulation tissue by drilling holes in the cranium after chemical scalp burns, and to determine the process of grafting and clinical practice.
 A 55-year-old male patient was admitted to the emergency department after a chemical burn (nitric acid). He was admitted to the burn center with 20% of the total chemical burn being in the third degree, especially on the head and chest area. The patient was treated with debridement. Since the cranial periosteum was burned, the defect was wide and there was a chemical burn for the second time, graft and flap surgeries could not be performed. Multiple holes were drilled on the skull. Approximately a month later, granulation was observed in all holes in the cranium. The granulated areas in the skull were cleaned and debrided. The defect in the cranium was closed with a split thickness graft. Approximately 15 days later, he was discharged from the hospital. Therefore, after exposure to nitric acid, more than half of the scalp was burned to the bone. After the necrotic tissues were cleaned, the skull bones appeared. Since graft and flap surgeries could not be performed, granulation was stimulated on the cranium by opening holes in the skull.