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Comment & Response
May/Jun 2016

Healing by Secondary Intention—Reply

Author Affiliations
  • 1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor
JAMA Facial Plast Surg. 2016;18(3):233. doi:10.1001/jamafacial.2016.0061

In Reply We would like to thank Dr Thomas1 for illustrating the excellent results that can be obtained with conservative treatment of scalp defects secondary to Mohs dermatographic surgery. We agree, that in the appropriately selected and counseled patient, that granulation can produce an excellent result in patients with hair loss. As pointed out, granulation is most suitable for superficial defects in which subcutaneous fat or pericranium is present and the patient wishes to avoid surgical intervention. The main downside of granulation is the daily wound care required and the potential for an unpredictable, hyperemic scar that may infrequently occur in certain patients.