In a twenty-five year period (1958—1983) ,there were 1255 children admited to this institute because of various kinds of burn injuries.The overall death rate was 4.7% (59 cases) .The causes of death were septicemia (30 cases),shock (17),cerebral edema and hernia(4),acute renal failure(4),severe burn wound scepsis(2),and complications resulting ftom severe inhalation injuries(2).The burned children were characterized by the following:1. Children made up 26.9% of all the burn patients admitted during the above-mentioned period.2. 64.06% of the children were younger than 5 years of age.3. Most injuries (64.46%) occurred in the hot season (foom May to September).4. 96% of the children were injured indoorly.5. The male to female ratio was 1.5:1.6. Scalding was the main cause of the barn injuries in those younger than 5 years of age,and it accounted for 81.76% of all the injuries.Since the death rate of burn patients is closely related to the extent of the burned area,a"1-3-5"category method for children burn cases is suggested as follows:1. Mild burns:The affected area is less than 10% TBSA.2. Moderate burns:The affected area is between 11～30% TBSA.3. Severe burns:The affected area is between 31～50% TBSA.4. Extreme severe burns:The affected area is more than 50% TBSA.

OBJECTIVETo investigate the clinical therapeutic effects of in situ re-grafting of the scalp skin flap after its covering of the exposed devitalized skull following electrical injury.

METHODSThe scalp wounds were debrided during the early postburn stage and the necrotic skull was preserved. The wounds with necrotic skull were then covered with an adjacent scalp skin flap. The grafted scalp skin flap was re-grafted back to the donor site 3 - 6 months after the first operation. The remaining scalp wound with fresh granulation tissue was recovered with split-thickness skin grafts.

RESULTSTen scalp skin flaps were applied in 8 cases of electrical injury of the skull with the maximal defect of 24 cm x 10 cm and all survived very well free from infection or necrosis. The wounds were closed primarily.

CONCLUSIONIn situ re-grafting of the scalp skin flap after its covering of the exposed devitalized skull following electrical injury shortened the wound healing time with satisfactory contour.

Adult ; Burns, Electric ; surgery ; Female ; Humans ; Male ; Middle Aged ; Scalp ; injuries ; surgery ; Skin Transplantation ; methods ; Surgical Flaps ; Time Factors ; Wound Healing