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.
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