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A missed scalp laceration causing avoidable sequelae.

Shadi Basyuni1, Andreana Panayi1, Valmiki Sharma2

  • 1Addenbrooke's Hospital, Cambridge, United Kingdom; University of Cambridge, United Kingdom.

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|April 19, 2016
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Summary

A missed scalp laceration in a polytrauma patient led to complications and extensive treatment. Thorough secondary surveys are crucial to avoid diagnostic errors in severe injury cases.

Keywords:
InfectionLacerationMaxillofacialReconstructiveSecondary surveyWound healing

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Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Diagnostic Imaging

Background:

  • Presents a case of an 81-year-old female with polytrauma after a fall.
  • An overlooked scalp laceration resulted in significant complications.

Purpose of the Study:

  • To highlight the importance of thorough secondary surveys in polytrauma patients.
  • To emphasize the potential for diagnostic errors in complex injury presentations.

Main Methods:

  • Initial imaging revealed multiple fractures and a cranial hematoma.
  • Acute anemia prompted a detailed scalp examination, revealing a large laceration.
  • Infection and necrosis necessitated surgical debridement and closure under general anesthesia.

Main Results:

  • The missed scalp laceration led to acute anemia requiring blood transfusion.
  • Infection and necrotic tissue developed, necessitating extensive surgical intervention.
  • Delayed diagnosis resulted in more complex treatment than if identified early.

Conclusions:

  • Diagnostic errors are more frequent in patients with multiple or severe injuries.
  • Thorough wound examination, including adequate cleaning, is vital to identify all injuries.
  • Effective secondary surveys are essential to prevent complications from overlooked injuries.