A clear understanding of the basic principles of wound healing, scalp vascular anatomy, atraumatic tissue handling, closure, and reconstruction techniques are necessary for planning scalp incisions.
Figure 1: These photographs show two of Harvey Cushing’s patients who suffered from postoperative fungus cerebri (ulcerated brain herniations through incompletely healed incisions). Cushing’s meticulous compulsion for strict aseptic Halstedian handling of wounds minimized this dreadful complication to allow neurologic surgery to survive its infancy in the face of its critics (Images courtesy of the Cushing Brain Tumor Registry at Yale University.)
The process of wound healing can be divided into inflammatory, proliferative, and maturation phases. Polymorphonuclear leukocytes...