Skip to main content
Log in

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

  • Case Report
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

An Erratum to this article was published on 14 April 2015

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

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Beasley NJP, Gilbert RW, Gullane PJ, Brown DH, Irish JC, Neligan PC (2004) Scalp and forehead reconstruction using free revascularized tissue transfer. Arch Facial Plast Surg 6(16):16–20

    Article  PubMed  Google Scholar 

  2. Wright HR, Drake DB, Gear AJ, Wheeler JC, Edlich RF (1997) Industrial high-voltage electrical burn of the skull, a preventable injury. J Emerg Med 15(3):345–9

    Article  CAS  PubMed  Google Scholar 

  3. Lutz BS, Wei FS, Chen HC, Lin CH, Wei CY (1998) Reconstructive of scalp defects with free flaps in 30 cases. Br J Plast Surg 51:186–90

    Article  CAS  PubMed  Google Scholar 

  4. Pennington DG, Stern HS, Lee KK (1989) Free-flap reconstruction of extensive scalp defects. Plast Reconstr Surg 83:655–61

    Article  CAS  PubMed  Google Scholar 

  5. Yalcın OYT, Kızılkılıc O, Hurcan CE, Koc Z, Aydın V, Şen O, Kayaselcuk F (2007) CT and MRI findings in calvarial non-infectious lesions. Diagn Interv Radiol 13:68–74

    PubMed  Google Scholar 

  6. TerKonda RP, Sykes JM (1997) Concepts in scalp and forehead reconstruction. Otolaryngol Clin North Am 30:519–39

    CAS  PubMed  Google Scholar 

  7. Chai J, Song H, Sheng Z, Chen B, Yang H, Li L (2003) Repair and reconstruction of massively damaged burn wounds. Burns 29(7):726–32

    Article  PubMed  Google Scholar 

  8. Sarıkaya A, Aygıt AC (2003) Combined 99mTc MDP bone SPECT and 99mTc sestamibi muscle SPECT for assessment of bone regrowth and free muscle flap viability in an electrical burn of scalp. Burns 29(4):385–8

    Article  PubMed  Google Scholar 

  9. Hettiaratchy S, Dziewulski P (2004) Pathophysiology and types of burns. BMJ 12(328):1429

    Google Scholar 

  10. Dalay C, Kesiktas E, Yavuz M, Ozerdem G, Acarturk S (2006) Coverage of scalp defects following contact electrical burns to the head: a clinical series. Burns 32(2):201–7

    Article  PubMed  Google Scholar 

  11. Cruz NI, Saavedra FM (2010) Preservation of nonviable cranial bone after class IV electrical burns. P R Health Sci J 29(1):83–5

    PubMed  Google Scholar 

  12. Bizhko IP, Slesarenko SV (1992) Operative treatment of deep burns of the scalp and skull. Burns 18(3):220–3

    Article  CAS  PubMed  Google Scholar 

  13. Spies M, McCauley RL, Mudge BP, Herndon DN (2003) Management of acute calvarial burns in children. J Trauma 54(4):765–9

    Article  PubMed  Google Scholar 

  14. Chiu DT, Sherman JE, Edgerton BW (1984) Coverage of the calvarium with a free parascapular flap. Ann Plast Surg 12(1):60–6

    Article  CAS  PubMed  Google Scholar 

  15. Ioannides C, Fossion E, McGrouther AD (1999) Reconstruction for large defects of the scalp and cranium. J Cranio-Maxillofac Surg 27(3):145–52

    Article  CAS  Google Scholar 

  16. Worthen EF (1971) Regeneration of the skull following a deep electrical burn. Plast Reconstr Surg 48(1):1–4

    Article  CAS  PubMed  Google Scholar 

  17. Gümüş N, Coban YK, Reyhan M (2006) Cranial bone sequestration 3 years after electrical burn. Burns 32(6):780–2

    Article  PubMed  Google Scholar 

  18. Henckel von Donnersmarck G, Mühlbauer W, Herndl E, Schmidt A. Reconstruction of the cranial vault and soft tissues of the skull after electrotrauma. Langenbecks Archiv für Chirurgie. 1989;847-51.

  19. Hunt J, Lewis S, Parkey R, Baxter C (1979) The use of Technetium-99 m stannous pyrophosphate scintigraphy to identify muscle damage in acute electric burns. J Trauma 19(6):409–13

    Article  CAS  PubMed  Google Scholar 

  20. Kao PF, Tzen KY, Chang LY, You DL, Yang JY (1997) 99Tcm-MDP scintigraphy in high-voltage electrical burn patients. Nucl Med Commun 18(9):846–52

    Article  CAS  PubMed  Google Scholar 

  21. Chicarilli ZN, Ariyan S, Cuono CB (1986) Single-stage repair of complex scalp and cranial defects with the free radial forearm flap. Plast Reconstr Surg 77(4):577–85

    Article  CAS  PubMed  Google Scholar 

  22. Ozkan O, Coskunfirat OK, Ozgentas HE, Derin A (2005) Rationale for reconstruction of large scalp defects using the anterolateral thigh flap: structural and aesthetic outcomes. J Reconstr Microsurg 21(8):539–45

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Sarah Strathie Page, Alexandra Murray, Thomas Jovic, Martin Ball and Jeremy Rawlins declare that they have no conflict of interest.

Patient consent

Informed consent was obtained from all individual participants included in this study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article. We also have written consent for all pictures/information that applies to patients that are mentioned in this manuscript.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with human participants performed by any of the authors. This complies with the ethical standards set out by Royal Perth Hospital, Perth, Western Australia for case series/reports.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarah Strathie Page.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Page, S.S., Murray, A., Jovic, T. et al. The reconstructive challenges of electrical burns to the scalp: A case series. Eur J Plast Surg 38, 229–234 (2015). https://doi.org/10.1007/s00238-015-1072-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-015-1072-7

Keywords

Navigation