PMC7997828_01
Preoperative photograph. Patient lying supine; right 6 x 4-cm paramedian oval defect.
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F1
C.W. was a 39-year-old white woman, mother of 5, with a history of depression who presented with an enlarging full-thickness right paramedial scalp wound (Fig 1).
Surgical photograph. Taken after neurosurgery assessment, plastic and reconstructive surgery debridement, and Integra placement and securement.
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F2
Stage 1 included debridement, bone burring and placement of a dermal matrix template, and negative pressure wound therapy (NPWT) (Fig 2).
Surgical photograph. Five weeks post-Integra placement. (a) Integra silicone outer layer removed with evidence of graft vascular integrity. (b) After placement of meshed split-thickness skin graft.
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F3
Stage 2 took place 5 weeks later with placement of a meshed split-thickness skin graft (Fig 3).
Postoperative photograph. (a) Three-week follow-up from split-thickness skin graft placement. (b) Three-month follow-up.
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F4
Reconstruction was successful, and the patient is doing well amidst ongoing psychiatric challenges (Fig 4).