The scalp as a donor site for skin grafting in burns: retrospective study on complications

Dorota Teresa Roodbergen; Adrianus Fredericus Petrus Maria Vloemans; Zjir Mezjda Rashaan; Jacob Cornelis Broertjes; Roelf Simon Breederveld

doi:10.1186/s41038-016-0042-z

The scalp as a donor site for skin grafting in burns: retrospective study on complications

Burns Trauma. 2016 Jul 13:4:20. doi: 10.1186/s41038-016-0042-z. eCollection 2016.

Authors

Dorota Teresa Roodbergen¹, Adrianus Fredericus Petrus Maria Vloemans¹, Zjir Mezjda Rashaan², Jacob Cornelis Broertjes², Roelf Simon Breederveld³

Affiliations

¹ Burn Centre, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands.
² Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands.
³ Burn Centre, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands ; Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands ; Department of Surgery, University Medical Centre Leiden, Leiden, The Netherlands.

Abstract

Background: Split skin grafting (SSG) is the cornerstone in the treatment of deep burns and large skin defects. Frequently used donor sites are the thigh, abdomen and buttocks. The scalp is less common while considered as a reliable donor site. Advantages are a large surface area, rapid wound healing, cosmetically favourable results and multiple harvests from the same donor site. Complications include scab formation, chronic folliculitis and alopecia but have been recorded sporadically in previous studies. This article evaluates the complication rate of the scalp donor site in the treatment of deep burns in the Beverwijk Burn Centre.

Methods: A retrospective study was performed of all patients who received a skin graft from the scalp at the Beverwijk Burn Centre between January 2004 and December 2012. Data were collected from medical files of included patients, including gender, age, type of burn (scald, flame, other) and total body surface area (TBSA) burned at the time of first surgery. Postoperative variables were healing time of the donor site and incidence of complications. During follow-up, the incidence of late complications was reviewed.

Results: A total number of 105 grafts were analysed in 93 patients: 58 males (62 %) and 35 females (38 %), with a median age of 2 years and 3 months old. Of the patients, 30 (32 %) had flame burns and 57 (61 %) had scald burns. Eighty-seven percent of patients had a TBSA burned of 5 % or less. All donor sites healed within 14 days. No alopecia or scar hypertrophy developed at the donor sites. Two patients (2.2 %) developed folliculitis; one patient (1.1 %) showed scab formation.

Conclusions: The scalp as a donor site in our Burn Centre shows a comparable short-term complication rate to the previous literature, with quick healing and no long-term complications. Therefore, we propose the consideration of the scalp as a primary donor site, especially in young children, where the scalp offers a larger donor site area than the buttocks or thighs.

Keywords: Burn; Donor site; Graft; Scalp.