Reconstruction of a Deep Burn Involving Cranial BoneUsing a Free Latissimus Dorsi Flap

Abstract

 The patient was a 76-year-old female who was found lying unconscious on the floor in front of a heater in her house. She had a 14x11cm deep burn on the left side of her head. On post-burn day 2, we performed debridement of the necrotic soft tissue to the cranial bone, which was partially exposed, and full-thickness scalp defects were then covered with artificial dermis. However, sufficient granulation was not achieved, and the surrounding preserved galea and periosteum became necrotic. On post-burn day 17, we excised the outer layer of the cranial bone to the level of bleeding, and applied a free latissimus dorsi muscle flap and split-thickness skin grafting to cover the defect. We consider covering the exposed cranial bone with a vascularized free flap at an early stage to be a useful reconstructive method to control the progression of necrosis and infection of the exposed bone.