LACERATIONS of the scalp may end with almost fatal complications. This is especially true if the patient has an unsuspected diabetes. Since the advent of sulfonamides, penicillin and other antibiotics, they may be slightly less serious, but 2 patients, recently admitted to this hospital, illustrate how poor is the outcome when the initial treatment is inadequate.
Botterell and Jefferson1 pointed out that Briesen found, in a review of over five thousand head injuries in Los Angeles, that the longest periods of hospitalization were due to septic wounds of the scalp. Another factor which they call attention to is "that an infected scalp wound makes it impossible to undertake exploratory punctures of the skull and dura as the later progress of the case may demand." In neither of our cases were exploratory punctures necessary, but it remains an important consideration.
—M. R., a 65 year old Iroquois
MOORE JR, GERRIE J, ELLIOTT H. MASSIVE CELLULITIS OF THE SCALP IN PERSONS WITH DIABETES. Arch Surg. 1950;60(5):897–905. doi:10.1001/archsurg.1950.01250010920007