Successful partial-thickness skin grafting in a pediatric scalp avulsion after dog bite: A case report

Animal bites can cause significant head and neck injuries in children with scalp avulsions posing a challenge. This report presents a case of successful partial-thickness skin grafting in managing a severe pediatric scalp avulsion from a dog bite.

A 7-year-old boy who sustained extensive scalp injuries following a dog attack was admitted to the emergency room. The patient presented in hypovolemic shock with deep lacerations and full-thickness soft tissue avulsion involving the frontal, parietal, and occipital regions of the scalp. Initial treatment included fluid resuscitation, antimicrobial prophylaxis, and wound stabilization. Over a 45-day period, the patient underwent multiple debridements, resection of the outer cortex of the scalp bone, and preparation of the wound bed with a vacuum-assisted closure (VAC) device. Partial-thickness skin grafts (PTSGs) were harvested from the anterior thighs and successfully applied to the granulation tissue, resulting in a graft take rate exceeding 90 %. The patient was discharged in good condition with a satisfactory outcome.

The case underscores the efficacy of PTSGs in managing extensive scalp defects in pediatric patients. The technique offers several advantages, including quicker donor site healing, adaptability to irregular surfaces, and a high success rate in challenging wound beds. Compared to other reconstruction methods, PTSG is particularly beneficial when donor sites are limited.

This case report highlights the successful use of PTSGs in the treatment of a severe pediatric scalp avulsion, demonstrating its viability as a reliable option for extensive scalp reconstruction in children.