Occam’s razor is a principle often paraphrased as “All other things being equal, the simplest solution is the best.”  In other words, of two possible solutions to solve a problem, the less complicated one is preferred.  This case study illustrates the clinical approach used in the treatment of a large scalp and forehead wound; the less complicated surgical option was favored.  A 56-year-old woman presented with multiple comminuted facial fractures, a closed head injury, and mutilating lacerations after being severely beaten about the face and head.  The facial fractures and lacerations were repaired and tracheostomy was performed for airway management.  Subsequently, patient developed necrosis of the scalp requiring surgical debridement.  Surgical debridement included excision of the entire thickness of the soft tissue of the scalp, exposing a 22cm by 12 cm wound down to intact skull. Free flap reconstruction was considered initially secondary to the large size of the defect.  Given the history of HIV, substance abuse, noncompliance, malnourishment, and wound infection with MRSA and pseudomonas, we felt that the risks of complications and likelihood of failure with this treatment outweighed the benefits.  Alternatively, treatment with Bilayer Matrix Wound Dressing along with Negative Pressure Wound Therapy was implemented and was followed by spilt-thickness skin graft. Results: The use of tissue engineered matrix in conjunction with Negative Pressure Wound Therapy and then split-thickness skin graft proved to be a successful, simple and the safe method of reconstruction for this patient with multiple comorbidities. This modality led to complete healing without any complications or adverse effects.  Conclusion: Reconstruction of large scalp and forehead wounds poses a particularly challenging clinical dilemma.  The simplest and safest method of reconstruction should be considered in all cases.