A 6 year-old boy fell out of a tree and cracked his skull. His family took him to various hospitals, but due to financial constraints, the boy did not get the proper treatment.
Fast-forward 2 years, the boy and his family leave Burkina Faso and show up at BMC. The boy’s head is wrapped in a bandage which when unraveled reveals the raw edge of a broken bone sticking out of his scalp and bathed with pus.
An x-ray showed a sizeable gap in the skull, partially covered by this dead bone fragment.
I consulted a neurosurgeon who had worked for some time in East Africa and finally I decided to take the boy to the OR.
After the boy was intubated and given anesthesia, the theatre crew started to wash the head and prep him for the operation.
“Well, the surgery is done!” exclaimed the nurse who had easily removed the bone from is nest in the scalp. The real surgery, however, was closing the gap in the scalp skin. The edges of the skin were separated from the Dura that was exposed. The skin was “undermined” and separated from the tissue layers on the skull. The incision was extended minimally in order to give it more mobility and flexibility to cover the defect. Once the skin was sufficiently freed, I was able sew it closed. I was very happy with the result, as was the patient and his family.