Total scalp reconstruction following a dog bite in a pediatric patient

The purpose of this case report is to present the reconstruction of a full-thickness scalp defect in a 2-year-old Hispanic male mauled by a dog, which was performed by a novel technique. After the scalp defect was debrided multiple times and treated with greater than 600 cm of cryopreserved human skin allograft, Integra was applied to the scalp defect following debridement and burring-out the outer bony cortex to promote bleeding and integration, followed by the application of a VAC dressing. Four weeks later, the mature Integra was grafted with split-thickness grafts. One year after the original injury, the patient demonstrated 98% take of the skin grafts to the calvarium. The resultant soft-tissue cover was supple, pliable, uniform in texture, and stable. The proposed technique of reconstruction of large full-thickness scalp defects in pediatric patients is easily reproducible, involves a short operative time, and produces satisfying cosmetic results.