Managing scalp defects in sub-Saharan Africa

Abstract

Objectives: To determine the common aetiological factors of scalp defects, and outcome of management. Design: A two year prospective study. Setting: Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Subjects: All consecutive patients with scalp defect from January 2001 to December 2002. Main outcome measures: Size of defect, associated bone loss, osteomyelitis, type of surgery, duration of hospital stay and complications of surgery. Interventions: Patients went through a simple management protocol involving history, clinical examination, relevant tests and appropriate treatment, including surgery. Results: A total of 27 patients were studied out of which 15 were males and 12 females, giving a male to female ratio of 1.25: 1. The age range was seven months - 42 years (mean = 13.9 years). Road Traffic Accidents (RTAs) was the commonest cause of scalp defects (81.5%). The temporo-parietal area was involved in over 50% of patients. Chronicity and osteomyelitis were common complications of the defects. Over 50% of the patients had local flap reconstruction. Conclusions: Management of scalp defects remains a major challenge in our environment. The importance of continuing education of colleagues and other health workers in peripheral health units on the importance of proper initial wound debridement and early referral cannot be overemphasised.