Abstract
Introduction: Electrical burns are potentially devastating injuries and most often occur at the workplace. Scalp defects following electrical burns are a rare occurrence and usually present as a reconstructive challenge. Case Presentation: Male, 31 years old, suffered a high voltage electrical burn at work that resulted in a scalp defect with exposed bone and a third degree burn in the left leg and foot complicated by a compartment syndrome, which needed an emergent fasciotomy and later an amputation below the knee. The scalp defect was covered by a local transposition flap and a skin graft. At 3 months post-operatively flap survived completely with no necrosis or other complications. A satisfactory cosmesis and preservation of scalp contour were achieved. Conclusion: Reconstructive ladder must be respected in reconstruction of these rare and complex defects. Local transposition flaps, if available, are often an ideal choice for scalp reconstruction in that the adjacent tissue is of similar quality to the original defect tissue with a long-term durability, contour preservation, minimal donor site morbidity and an acceptable cosmesis.
Highlights
Electrical burns are potentially devastating injuries and most often occur at the workplace
Case Presentation: Male, 31 years old, suffered a high voltage electrical burn at work that resulted in a scalp defect with exposed bone and a third degree burn in the left leg and foot complicated by a compartment syndrome, which needed an emergent fasciotomy and later an amputation below the knee
The scalp defect was covered by a local transposition flap and a skin graft
Summary
Electrical burns are potentially devastating injuries and most often occur at the workplace. The patient is a 31-year-old man registered in May 2019 in the emergency room at Hospital São José, Lisbon, Portugal He suffered an electrical burn through a high voltage electric cable contact (2000 volts) at the workplace. At the physical exam it was found an 4% area of third degree burn with scalp as the entry point and left foot as the exit point of the electricity It was complicated by a compartment syndrome in the left leg and foot, conditioning an emergent fasciotomy and few days later an amputation below the knee. He developed acute kidney injury with hyperkalaemia, a rising creatine kinase and myoglobinuria. At 3 months post-operatively flap survived completely, and skin graft was adherent but with an area of alopecia which can be corrected in the future
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