Combined Plastic Surgical Reconstruction of Pediatric Scalp Injuries Associated with Craniocerebral Trauma

Abstract

Background: Timely, vascularized coverage of traumatic pediatric scalp defects may be required alongside neurosurgical treatment. A previously published 57-patient cohort reported outcomes after a combined reconstructive approach, but its numerical summary contains inconsistencies. Objective: To re-examine the published aggregate outcomes, clarify what can be inferred about a modified local-flap technique, and place the findings in a pediatric reconstructive context. Methods: We performed a secondary descriptive analysis of aggregate data published by Khodjaliyev and colleagues in 2026. The original report described 31 children treated with an improved approach and 26 comparison patients treated with a traditional approach at two emergency-care centers in 2022–2025. Integer counts were preferred to inconsistent printed percentages; exploratory group comparisons used two-sided Fisher exact tests. No patient-level data were accessed. Results: The source reported good or satisfactory outcomes for 26/31 (83.9%) in the improved group and 69.2% in the comparison group, equivalent to 18/26 patients if its percentage is accurate. The absolute difference was 14.7 percentage points (exploratory Fisher p=0.220). Implant exposure was described in 5/31 (16.1%) versus 8/26 (30.8%; p=0.220). Distal flap-tip necrosis was described in 0/31 versus 4/26 (15.4%; p=0.038), but event definitions, follow-up, and baseline comparability were insufficiently reported. The original conclusion mislabels 8/26 as 69.2% and 5/31 as 14.7%. Conclusions: The published experience supports the feasibility of coordinated neurosurgical and scalp reconstruction in selected children, but does not establish that the modified technique improves overall outcomes. Verification of the original case records and a clearly defined prospective endpoint are needed before making efficacy claims.