Banana Peel Flap for Reconstruction of Scalp Defect in Electrical

Burn Injury
Yesica*, Siti Osnurlita Ekasepti*, Guntoro*
*
Departement of Plastic Surgery, Gatot Soebroto Army Central Hospital, Jakarta, Indonesia

Background : Electrical burns and burn related morbidity and mortality are
increasing due to the use of electricity in all areas of life. Electrical injuries represent
4% of the patients admitted to burn centers and are more common in males. Severity
of damage depends on voltage, type of current, duration of contact and tissue
resistance. Scalp defects following electrical burns are a rare occurrence and usually
present as a reconstructive challenge. The repair of defects is dependent upon their
location, size, and depth. Rotation, advancement, and transposition scalp flaps are the
reference for reconstructing these defects. Defects larger than 3 cm should be covered
by a single or multiple flaps such as a “banana peel” method.
Patient and Methods : a 35-years old man with a history of electrical burn injury on
his scalp after previous surgery in other hospital 2 months ago, came to Gatot
Soebroto Army Hospital for scalp defect construction. Third degree burn wound sized
10x8cm with skin, soft tissue, and bone necrosis affected the right fronto-parietal
region. Since there is a bone exposure, skin grafting is unable to be carried out, so
"flap" is performed. However, only a two-sided flap was performed for this instance
as the patient has a previous operation which resulted in a scar on his scalp - making a
three-sided peel impossible for this occasion. The secondary defect resulting from the
flap covered with FTSG.
Result : Scalp defect was successfully closed by this two-sides flap of banana peel
technique, aesthetic result was fair, and might need further treatment. After further
follow-up for several months later, it was found that the wound is healing well.
Conclusion : The used of banana peel flap as a scalp defect reconstruction could be a
recommended option. This takes advantage of the excess skin that can be mobilized
from the neck
Keywords : electrical burn injury, banana peel flap, scalp defect.