The Use of Integra in Extensive Full-Thickness Scalp Burn Involving the Skull in a Child

Extensive full-thickness burn injury of the scalp involving the skull is a challenge to reconstruct. Here, the authors report a case of a 6-year old girl who suffered extensive flame burn injury involving a scalp defect of 1,5% total body surface area. After necrosectomy, full table damage of the skull was observed with a partially exposed dura mater. Neurosurgical consultation was necessary to accomplish a vital wound bed. Subsequently, in the absence of enough adequate tissue available for flap surgery reconstruction, reconstruction was performed by using a bilayer Integra Dermal Regeneration Template (IDRT) resulting in a lasting and stable coverage of the defect. This is the first case-report describing application of IDRT on a full-thickness scalp and skull defect with exposed dura mater in a child. Our results are encouraging and demonstrate that Integra can be used in a child to successfully cover exposed dura when no viable skull remains. Address correspondence and reprint requests to Kim L.M. Gardien, MD, Rode Kruis Ziekenhuis, Brandwondencentrum, Vondellaan 13, 1942 LE Beverwijk, The Netherlands; E-mail: kgardien@rkz.nl, Louise E.M. de Haas, Brandwondencentrum, Rode Kruis Ziekenhuis, Vondellaan 13, 1942 LE Beverwijk, The Netherlands; E-mail: ldehaas@rkz.nl Received 9 August, 2018 Accepted 11 January, 2019 Informed consent was obtained from both parents. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. Author contributions: LH carried out the conception and design of this review and drafted the manuscript. DB drafted the manuscript and made substantial contributions on all neurosurgical aspects. KG, AT, and AV made substantial contributions to the manuscript on dermal substitutes, the Integra Dermal Regeneration Template and specific details of the case respectively. KG, AT, and DB critically read and revised the manuscript. All authors gave final approval of the version to be submitted. © 2019 by Mutaz B. Habal, MD.

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