case_images: PMC7997828_01
case_images: Preoperative photograph. Patient lying supine; right 6 x 4-cm paramedian oval defect.
case_images: eplasty21ic03_fig1.jpg
case_images: PMC7997828_01_eplasty21ic03_fig1.jpg
case_images: F1
case_images: 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).
case_images: Surgical photograph. Taken after neurosurgery assessment, plastic and reconstructive surgery debridement, and Integra placement and securement.
case_images: eplasty21ic03_fig2.jpg
case_images: PMC7997828_01_eplasty21ic03_fig2.jpg
case_images: F2
case_images: Stage 1 included debridement, bone burring and placement of a dermal matrix template, and negative pressure wound therapy (NPWT) (Fig 2).
case_images: 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.
case_images: eplasty21ic03_fig3.jpg
case_images: PMC7997828_01_eplasty21ic03_fig3.jpg
case_images: F3
case_images: Stage 2 took place 5 weeks later with placement of a meshed split-thickness skin graft (Fig 3).
case_images: Postoperative photograph. (a) Three-week follow-up from split-thickness skin graft placement. (b) Three-month follow-up.
case_images: eplasty21ic03_fig4.jpg
case_images: PMC7997828_01_eplasty21ic03_fig4.jpg
case_images: F4
case_images: Reconstruction was successful, and the patient is doing well amidst ongoing psychiatric challenges (Fig 4).