OTHR-11 A CASE SERIES OF OUTER TABLE CALVARIAL DECORTICATION AS A VIABLE OPTION TO ACHIEVE SKULL COVER AFTER RESECTION OF LARGE SCALP TUMORS

A showcase of a scalp cover technique that offers a simple solution to a unique challenge posed by excision of late presenting large scalp tumors in a third-world setting through a case series of 2 patients with extensive scalp malignancy requiring wide local excision with striping of the pericranium. Outer table skull drilling resulted in granulation tissue formation allowing for defect cover by wound contraction. Unique circumstances in a third-world setting compounded by the COVID-19 pandemic restrictions allowed for observation of the natural history of the progression of the scalp defect coverage by wound contraction over a decorticated granulation tissue bed. An adequate granulation bed can be achieved within 4-6 weeks. Closure of the defect by wound contraction over the granulation bed is possible, albeit over a protracted period of months. These two cases proved that outer table decortication offers a good option to cover denuded large scalp defects after the excision of scalp tumors. Although less than ideal, total defect closure can be achieved without subsequent grating.