Operative treatment of deep burns of the scalp and skull

Traditional surgical treatment of deep burns of the scalp and skull involve the excision of necrotic bone and soft tissues with trephanation of the bone to permit granulation tissue formation and subsequent grafting. This approach prolongs wound time, adds additional trauma and, even after initial healing, necessitates secondary soft tissue and bone reconstruction. The treatment described here is an alternate and more aggressive one involving early excision of necrotic soft tissue without bone resection followed by immediate coverage with well-vascularized axial flaps from adjacent intact scalp. This method provides an optimal environment for healing and regeneration of areas of destruction to the skull. This surgical method was used in the treatment of 22 patients with deep burns of the scalp with satisfactory clinical results. Bone regeneration was confirmed by roentgenological investigations.