Scalp defects in old polymorbid patients are still therapeutic challenge for reconstructive surgeons. We present the case of a male who underwent an excessive tumour resection with the unsuccessful skin graft coverage. The patient developed a progressive skin graft necrosis and infection with an exposure of calvarial bone. Initial surgical debridement and topical treatment resulted in an excessive bone exposure. We decided to use a negative pressure therapy after multiple bone trephinations, to improve growth of new vital tissue in bone-exposed area. This maneuverer, followed by a split thickness skin graft coverage, allowed a progressive defect healing. In such old polymorbid patient, calvarial bone trephinations with a negative pressure therapy could be considered to achieve effective and considerable results (Fig. 4, Ref. 16).
Keywords: negative pressure therapy; polymorbidity.; scalp reconstruction.