Surgical treatment of a newborn child with congenital aplasia of the scalp

Abstract

Introduction. Skin aplasia is a developmental defect represented by a skin defect of varying extent, often in combination with the defect of underlying tissues – subcutaneous fat, muscles and with various forms of dysraphy - non-closured embryonic slits. By various authors, defect frequency ranges from 1 per 1 000 to 1 per 10 000 newborns. Congenital focal aplasia of the skin and subcutaneous tissues can be located in limited areas; most often it is diagnosed on the scalp looking like single or multiple focal skin defects. Quite often, focal aplasia also affects the skin on the trunk and limbs.
 Description of observation. The article presents a clinical case of congenital focal aplasia of the scalp and skull bones in a newborn child. This type of skin congenital aplasia by I. Frieden classification corresponds to Group I of congenital aplasia of the skin with lesions on the scalp. At the expert examination with multispiral computed tomography, the absence of parietal bone was diagnosed. So, the defect bottom was dura mater. In this case, the authors considered conservative approach to be unacceptable because of long period of healing and high risk of secondary infection. The performed surgery has led to a satisfactory cosmetic result. The state of bone structures was assessed catamnetically.
 Conclusion. Modern diagnostic techniques have proven that an active surgical tactics in children with congenital aplasia of the scalp is justified.