Outcomes of Cortical Bone Fenestration Performed on the Denuded Frontal Bone to Induce Granulation Tissue Growth: A Case Study

Abstract

Open wounds with denuded bone may pose a challenge for surgeons if primary closure or flap surgery is not feasible. In such cases, cortical bone fenestration (CBF) has been employed as a preconditioning procedure to induce granulation tissue growth and provide a suitable bed for skin grafting or secondary intention healing. Our clinical study aimed to assess the outcomes of CBF performed on open wounds involving the denuded frontal bone. We treated a patient with multiple open wounds involving the denuded frontal bone using secondary intention healing in conjunction with CBF procedures and evaluated the outcomes of the fenestrated bones as well as the wound healing process at regular intervals. Granulation tissue did not develop on the fenestrated bones throughout the healing process. However, the frontal wounds healed well without complications at 16 weeks after CBF through the centripetal migration of granulation tissue from the wound margins and simultaneous epithelialization. Our results suggest that CBF procedures that do not adequately expose the diploic space fail to induce granulation tissue growth and may not be needed to treat open wounds with less than 5 cm of denuded skull bone.