Application of superficial ultrasonography in diagnosing and guiding management of a refractory scalp wound complicated by epidural abscess.

A middle-aged patient presented with persistent purulent discharge from a scalp incision five years after undergoing craniotomy with artificial dura mater implantation. The wound showed no significant improvement despite a month of standardized treatment, including systemic antibiotic therapy and local debridement. Subsequent superficial ultrasonographic examination revealed complete separation of the artificial dura mater implant area from the surrounding flap tissue, with local blood supply loss. Guided by these findings, the artificial dura mater was surgically removed, and a free flap transplantation was performed to successfully cover the wound. The wound healed well at 10 months post-surgery.