Granulation tissue flap technique in extensive wounds for covering exposed bone after tumor excision

BACKGROUND. Second intention partial wound healing followed by skin grafting is a well-established method in dermatosurgery. In wide tumor excision, where periosteum is removed, growth of granulation tissue in the central areas of bare bone can be prolonged. OBJECTIVE. We describe a new technique for a faster, reliable closure of large defects utilizing granulation tissue flaps. METHODS. Postoperative wounds were treated with wet dressings until granulation tissue had developed on the wound edges. The central defects were then covered with lateral granulation tissue flaps. Subsequently split skin grafting was performed. RESULTS. Thirty-eight patients (37-39 years old) were treated between 1991 and 1999. Skin defects were located primarily on the scalp and forehead, and ranged from 3 to 13 cm in diameter. Wound bed preparation for skin grafting was achieved in all patients. Only minor complications, such as partial granulation flap necrosis in 5 of 38 patients or delayed skin graft healing in 4 of 38 patients, were seen. CONCLUSIONS. This technique for the closure of extensive skin defects is safe and effective.