Aplasia cutis congenita: failed conservative treatment.

Large scalp defects in aplasia cutis congenita present a management dilemma. In these lesions, prolonged conservative treatment may cause as much risk as does operative treatment. As a result of our experience, we suggest that one should be prepared to undertake early surgical intervention, rather than prolonged conservative treatment, for larger defects. Decreasing the size of the defect should decrease the risk of complications, since these appear to be related. The management of this condition should be a compromise of both operative and conservative modalities.