An evaluation of open scalp wounds

Area of Science:

• Trauma surgery
• Emergency medicine
• Orthopedic surgery

Background:

• Open scalp wounds are common injuries presenting to emergency departments.
• Understanding the etiology and characteristics of these wounds is essential for effective management.
• Skull fractures associated with scalp injuries require prompt and accurate diagnosis.

Purpose of the Study:

• To analyze the causes and characteristics of open scalp wounds in adult patients.
• To evaluate the diagnostic utility of wound exploration versus skull radiography for detecting fractures.
• To identify factors associated with a higher likelihood of skull fractures.

Main Methods:

• Retrospective study of 661 adult patients with open scalp wounds.
• Data collection included injury history, wound type (contused/incised), wound exploration findings, and radiological results.
• Analysis of injury causes, alcohol consumption, and association between wound characteristics and fractures.

Main Results:

• Assault (40%) and falls (34%) were the most common causes of injury.
• Contused wounds (84%) were more frequent than incised wounds (16%).
• Division of the occipitofrontalis aponeurosis, though infrequent (18%), was associated with a high fracture rate (78%); wound exploration identified 9 previously undetected fractures.

Conclusions:

• Careful wound exploration is a vital adjunct to skull radiography for maximizing fracture detection rates.
• Division of the occipitofrontalis aponeurosis should heighten suspicion for an underlying skull fracture.
• Emergency department management of open scalp wounds should incorporate thorough wound assessment to ensure timely diagnosis of associated fractures.