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John Hunt, MD; Gary Purdue, MD; Thomas Spicer, MD

Arch Surg. 1983;118(5):621-625.

Abstract
• Full-thickness burn injury of the scalp, with or without necrosis of underlying bone, is a complex therapeutic problem. Inability to diagnose depth of injury, controversy regarding wound closure, and a high incidence of acute morbidity are all associated with it. We reviewed the records of 17 patients who had suffered such injury. Wound closure was accomplished by split-thickness autograft alone in three patients, by bone dermabrasion and split-thickness autograft in six, by bone excision and split-thickness autograft in five, and by immediate local rotation flap in three. Systemic and/or local septic complications developed in 50% of all patients who underwent bony debridement. When feasible, early excision followed by immediate flap coverage is the procedure of choice. It avoids the multiple operative procedures required by the more conservative approach to wound closure, thereby shortening the period of primary hospitalization and virtually eliminating the risk of sepsis.

(Arch Surg 1983;118:621-625)

Author Affiliations
From the Departments of Surgery (Drs Hunt and Purdue) and Plastic and Reconstructive Surgery (Dr Spicer), University of Texas Health Science Center at Dallas.

Footnotes
Accepted for publication Jan 17, 1983.

Read before the 90th annual meeting of the Western Surgical Association, Kansas City, Mo, Nov 16, 1982.

Reprint requests to University of Texas Health Science Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Hunt).

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