Nitesh Kumar
Introduction
Clinicians face a number challenges when managing psychiatric patients who self-inflict injuries to the maxillofacial region. In addition to a complex clinical examination, there are both surgical and psychiatric factors to consider, such as the risk of damaging vital structures, the exacerbation of their psychiatric status, and the long-term psychosocial and aesthetic sequelae. Treatment are driven by a full assessment of the patient’s clinical, medical, social needs alongside a psychiatric assessment. Injuries to the scalp region are a common occurrence in oral and maxillofacial surgery. We report an interesting case of a self - inflicting injury to the scalp resulting in closure under general anaesthesia
Materials and methodology
A 27 -year-old female presented to us with an extensive wound on the anterior scalp. Her history revealed self - inflicted trauma to the scalp by self - inflicting factitious habit on a background of severe mental health.
Results
She had debridement of the scalp wound under general anaesthesia with a view to definitive repair with large scalp rotation flap. She returned to theatre for further debridement and definitive repair of the scalp wound and the wound was closed primarily under general anaesthesia.
Conclusion
Our case highlights the surgical management of a scalp wound under general anaesthesia. We advised a holistic approach utilising a multi-disciplinary approach, which is essential to provide the highest quality of care. A satisfactory aesthetic outcome is important in order to achieve long-term psychological and physical outcomes.
Authors
nitesh kumar
Somerset NHS foundation trust, somerset, United Kingdom
lochlan king
Somerset NHS foundation trust, somerset, United Kingdom
sonia chin sin
Somerset NHS foundation trust, Somerset, United Kingdom
teresa Turoung
Somerset NHS foundation trust, Somerset, United Kingdom
mostafa Abbas
Somerset NHS foundation trust, somerset, United Kingdom