[Acute Management of Electrical Scalp Burns with Calvarial Involvement: A Two-Case Report]

Scalp burns are usually easy to cure, thanks to the thickness of the dermis and to the great amount of hair follicles in this location. Unfortunately, in some cases of third-degree burns, full thickness of soft tissues is necrotized, requiring the use of local or free flaps to obtain wound healing. We present two cases of patients who suffered from full thickness burns of the scalp. They required skin debridement, followed in one case by bone debridement after CT scan and MRI were performed. Bone coverage has been done with local flaps for both cases. Donor sites of the flaps and partial thickness burnt areas were covered by split-thickness skin grafts. This kind of burn causes several problems. First, it can lead to venous thrombosis in superior longitudinal cerebral sinus, requiring a curative anticoagulation which can complicate surgical procedures. Second, the choice between local flaps and skin grafts can be challenging, due to the evaluation of burn depth and available healthy skin needed. Thus, this type of burn requires management in a burn center.