Technique of Granulation Tissue Genesis from Diploe

Introduction: Many techniques are used in surgery for importing scalp losses. Microsurgery reinsertion dominates these techniques. When reinsertion is not possible, other alternatives are available. Among these is the production of the granulation tissue by diploic perforation. Many authors have reported this technic without explaining the physiological mechanisms that contribute to the genesis of this granulation tissue from the diploe. We intend to recall them. Patients and Methods: This was a series of 3 cases supported for significant loss of the scalp. The technic consisted in making trepan drill holes and carrying the outer table to the diploe by using a Doyen drill. Then fat dressings were applied every other day until the formation of granulation tissue over the entire loss of tissue surface. Observations: Three patients benefited from this technique, 2 traumatic and the other one iatrogenic after a scalp tumor excision. The missing area of traumatic wounds was estimated at 18 and 25 cm2 respectively. The third patient had a loss of scalp after surgical removal of an ulcerous-budding tumor of the scalp without any impacting the skull. Granulation tissue was obtained in all cases after an average of 30 days. There was no infection. Two patients were grafted with favorable progress and one patient went under indirect wound healing. Conclusion: The ability of the diploe to generate granulation tissue is due to its intrinsic anatomical and functional potentialities. This is a technic of last resort when conventional reconstructive surgery is contraindicated for several reasons.