[Deep burns of the skullcap].

Deep burns of the skull are uncommon. In fire burned victims we sometimes found a necrosis of the outer table of the skull. Grafting with split thickness skin is generally successful, when the outer table is removed. Complete destruction of the skull was found in 2% of electrical injuries. The treatment with local rotation flaps gives good cover for the dura. The trapezius muscle flap or free flaps with microvascular anastomoses are alternative methods. Skull defects should be replaced with bone and we used autologous split grafts in three cases successfully. In order to replace hair loss, hair pieces and wigs were used. In some cases local flaps can introduce hair bearing skin.