Repair of Large Full-Thickness Scalp Defects Using Biomaterial and Skin Grafting

The reconstruction of large full-thickness scalp defects remains a surgical challenge, especially when the skull is exposed completely without periosteum. Surgical technique options for wound coverage have included tissue expansion, skin grafting, local or regional flaps, and microvascular free tissue transfer. In recent years, some authors have reported to use biological material as an alternative for repairing complex wounds. The authors report the successful reconstruction of a large defect with bare skull in bilateral temporal regions of a 3-year-old child. The patient was treated with artificial biomaterial followed by skin grafting, without making multiple cranial burr holes or burring out the outer bony cortex. The relevant literatures were reviewed and the vascular anatomy evidence of the blood supply at temporal region was also demonstrated on cadaver. This case suggests that artificial biomaterial followed by skin grafting is a potential alternative for the treatment of large full-thickness scalp defects in pediatric patients.