Purpose
High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis, which can result in chronic osteomyelitis (OM) of cranial bones despite successful flap coverage of soft tissue. The aim of this study is to understand treatment of chronic OM of the skull caused by high-voltage electrical burn injury.
Materials & Methods
A 37 year-old male patient was transferred due to a 22,000-voltage electrical burn on scalp. At first, a 4 × 3-cm-sized discolored scalp wound was noted. After repetitive debridementsof necrotic tissues, the scalp wound had enlarged to 12 × 12 cm with cranial bone exposure at postburnday (PBD) 45. On PBD 50, under general anesthesia, complete debridement of necrotic cortical bone and latissimus dorsimusculocutaneous (LD MC) free flap was performed, and the flap was survived well. After discharge, at PBD 4 month (postoperative day 2 month), a small opening was noted on the posterior site of the scalp wound accompanied by a small amount of discharge. The brain MRI and skull CT and whole body bone scan showed signs of cranial bone OM at the previous burn injury site. The wound healed and recurred repetitively with administration of IV antibiotics. At PBD 19 months (postoperative day 17.5 months), surgical exploration of the scalp wound was performed by both plastic surgeons and neurosurgeons. Debridement and craniectomy(necrotic outer table) were performed without flap loss. The inner cortical bone was viable and preserved.
Results
At 14 months after the craniectomy, the radiological findings of chronic OM almost subsided. No further antibiotics or other treatments were performed. The scalp and flap were good without wound recurrence for 30 months after craniectomy(debridement of the outer table).
Conclusion
The treatment of chronic OM by electrical burn is surgical debridement and well vascularized flap re-coverage. The LD muscle free flap is suitable not only for coverage of the skull, but also for the treatment of chronic OM of the skull.

**Purpose**
High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis, which can result in chronic osteomyelitis (OM) of cranial bones despite successful flap coverage of soft tissue. The aim of this study is to understand treatment of chronic OM of the skull caused by high-voltage electrical burn injury.
**Materials & Methods**
A 37 year-old male patient was transferred due to a 22,000-voltage electrical burn on scalp. At first, a 4 × 3-cm-sized discolored scalp wound was noted. After repetitive debridementsof necrotic tissues, the scalp wound had enlarged to 12 × 12 cm with cranial bone exposure at postburnday (PBD) 45. On PBD 50, under general anesthesia, complete debridement of necrotic cortical bone and latissimus dorsimusculocutaneous (LD MC) free flap was performed, and the flap was survived well. After discharge, at PBD 4 month (postoperative day 2 month), a small opening was noted on the posterior site of the scalp wound accompanied by a small amount of discharge. The brain MRI and skull CT and whole body bone scan showed signs of cranial bone OM at the previous burn injury site. The wound healed and recurred repetitively with administration of IV antibiotics. At PBD 19 months (postoperative day 17.5 months), surgical exploration of the scalp wound was performed by both plastic surgeons and neurosurgeons. Debridement and craniectomy(necrotic outer table) were performed without flap loss. The inner cortical bone was viable and preserved.
**Results**
At 14 months after the craniectomy, the radiological findings of chronic OM almost subsided. No further antibiotics or other treatments were performed. The scalp and flap were good without wound recurrence for 30 months after craniectomy(debridement of the outer table).
**Conclusion**
The treatment of chronic OM by electrical burn is surgical debridement and well vascularized flap re-coverage. The LD muscle free flap is suitable not only for coverage of the skull, but also for the treatment of chronic OM of the skull.

P.119 Chronic Osteomyelitis of Cranial Bones in a Patient with High-voltage Electrical Burn on the Scalp: A Case Report

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre