Scalp, skull, and dura reconstruction on an emergency basis

Severe cranial trauma caused by an industrial accident resulted in loss of scalp, skull, dura, and brain tissue in the left frontal region of a 55-year-old man. Successful one-stage total reconstruction of the defect was accomplished using a patch of fascia lata, autogenous split rib graft, and a free forearm flap on an emergency basis. A ten-month follow-up showed uneventful recovery and a good cosmetic result.