From 1990 to 1993 eight patients suffering from extensive deep burn of scalp with full-thickness necrosis of calvarial bone were treated. The intra-cranial damage following electrical injury or prolonged contact with heat source, and the extent of skull necrosis were delineated by CT and bone scanning. Primary coverage of the exposed calvarial bone using musculo-cutaneous flap or free skin flap was done, leaving the necrosed skull in situ to serve as a scaffold of "creeping substitution" for bone regeneration. Primary healing of the wound was achieved in four cases. Three cases required an average of 2.6 times of curettage or excision of the infected bone. None of the cases required a late reconstruction of the skull in this group.
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