The reconstructive challenges of electrical burns to the scalp: A case series

Abstract

Soft tissue or bony loss to the scalp and forehead present a reconstructive challenge, especially in the young patient. Much literature is available on scalp and forehead reconstruction for primary malignant pathologies, however reconstruction for contact electrical burns is reported infrequently in the literature. This case series looks at two patients with full thickness burns to the scalp and forehead requiring free flap reconstruction over 11 years at the Burns Unit at Royal Perth Hospital in Perth, Western Australia. We describe the flap reconstruction and outcomes of these patients and review the relevant literature. Three free flap reconstructions were performed on the two patients. The first patient had a free gracilis flap which failed five days post-operatively. 25 days post initial injury a free rectus flap was used to cover the predominantly forehead defect. The second patient had a free latissimus dorsi flap completed one week after initial injury. Free flap reconstruction of scalp and forehead following contact electrical burns is complicated and challenging. The outcomes of both of the patients in this case series was positive and both have had satisfactory flap survival at the time of writing. Due to rare nature of this type of burn there is little published evidence outlining the definitive management of this type of injury. Level of Evidence: Level V, therapeutic study