Calvarial burns involving the brain (Class IV) are reported to be rare. The
y represent a treatment challenge. Wound coverage can be accomplished with
serial debridement of bone and grafting over granulating tissue, local flap
s and free tissue transfer. The former techniques are often not feasible in
the young infant. We present a successful case of a six-week-old female pa
tient affected of full thickness burns involving the skull and brain. The b
one, dura mater and superficial brain were debrided and the defect covered
with AlloDerm(R) and split thickness grafts. The area engrafted completely
and no complications or CSF leak occurred. An acellular human allogeneic de
rmis (AlloDerm(R)) can be successfully used to replace dura mater in burn p
atients. (C) 1999 Elsevier Science Ltd and ISBI. All rights reserved.