High-voltage electrical injury: Modified surgical technique for optimal defect closuring of extra-large cranial defect.

Electrical burns are group of traumatic injuries with a mortality rate of 3-15%. High-voltage induced extensive electric burns are rarely seen in the cranial area, compared to upper and lower limbs, but extremely difficult for treatment, due to the limited flexibility in this area. The spectrum of therapeutic interventions in electrical burns in general, evolving initial necrectomy, decompression, and aggressive debridement with early skin coverage is usually not enough in cases of extensive cranial defects. The performance of a suitable flap combined with skin graft in donor site, and further implantation of expander is challenging in this area. We present a case of a high-voltage induced extra-large cranial injury in a 38-year-old man, treated with modified single large rotation flap and a split skin-thickness graft technique, for optimal defect closuring with satisfied aesthetic result.