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8Treatment - bone and soft-tissue reconstruction

Open cancellous bone grafting (Papineau technique), leaving the graft exposed beneath a nonadherent dressing, is a well-tried...

Open cancellous bone grafting (Papineau technique), leaving the graft exposed beneath a non-adherent dressing, is a well-tried technique for reconstructing defects. It is best used for strengthening partial segmental defects. It can achieve bony bridging and secondary soft-tissue coverage concurrently, since granulation tissue should form over the graft and under the moist dressing. A split-thickness skin graft can then be applied.

Some of the superficial bone graft is inevitably lost and will have to be removed before granulation occurs. This technique has a fairly high reported success rate.
A more modern adaptation is to use a VAC over cancellous bone graft.