ABSTRACT
High-tension electrical calvarial burns are extremely rare and difficult to reconstruct. Invariably, these are third- or fourth-degree-deep burns involving the bone and underlying brain. Historically, these wounds have been treated conservatively, adding to morbidity and prolonged treatment. Two patients with high-tension electrical calvarial burns presented to us 2 weeks after the injury, one fourth-degree deep with infected necrotic calvarium and scalp, resulting in a full-thickness frontoparietal defect with herniation of the brain. The other patient had third-degree burns over the occiput with surrounding second-degree-deep burns extending onto the nape of the neck with patches of second-degree deep burns over the vertex. Both patients had the risk for being subjected to prolonged anesthesia. The defects were covered with bipedicled scalp flap. In the face of sepsis and other comorbidities where more complicated flaps are risky, this flap provides a simple and reliable method of reconstruction.