The New York Eye & Ear Infirmary
Division of Facial Plastic and Reconstructive Surgery
310 E 14th St, Sixth Floor, North Bldg
New York, NY 10003
IT IS SCIENTIFICALLY ENLIGHTENING to read differing conclusions drawn in a study similar to one that you have performed. Our results and conclusions1 may differ from those of Kriet et al2 and Brodner et al3 because of technical issues related to measuring the force required to elevate periosteum from calvarium. Periosteal avulsion at a 45o angle from bone is not analogous to clinical situations, but was chosen for our study to provide a greater stress to wound healing than would any motion simulating sliding. We thus may have been able to discern subtler differences in healing at the soft tissue–hard tissue interface. Also, we have closed our wounds under no tension, again not directly clinically applicable; however, a prior study4 showed no significant differences in wound healing histologic characteristics between tension-free and tension-prone scalp-calvarium closures, and we do not believe this has a significant effect on closure strengths.
Sclafani AP, Romo T, Fozo M. Periosteal Healing. Arch Facial Plast Surg. 2003;5(2):202. doi:10.1001/archfaci.5.2.202